Department of Cardiac Surgery, The Leviev Cardiothoracic and Vascular Center, Sheba Medical Center, Tel Hashomer, Israel.
Sackler School of Medicine, Tel Aviv University, Ramat-Gan, Israel.
J Cardiothorac Surg. 2024 Jul 15;19(1):446. doi: 10.1186/s13019-024-02907-4.
The war that began on October 7th, 2023, has impacted all major tertiary medical centers in Israel. In the largest cardiac surgery department in Israel there has been a surprising increase in the number of open-heart procedures, despite having approximately 50% of surgeons recruited to military service. The purpose of this study is to characterize this increase in the number of operations performed during wartime and assess whether the national crisis has affected patient outcomes.
The study was based on a prospectively collected registry of 275 patients who underwent cardiac surgery or extracorporeal membrane oxygenation (ECMO) during the first two months of war, October 7th 2023 - December 7th 2023, as well as patients that underwent cardiac surgery during the same period of time in 2022 (October 7th, 2022 - December 7th, 2022).
120 patients (43.6%) were operated on in 2022, and 155 (56.4%) during wartime in 2023. This signifies a 33.0% increase in open-heart procedures (109 in 2022 vs. 145 in 2023, p-value 0.26). There were no significant differences in the baseline characteristics of patients when comparing the 2022 patients to those in 2023. No significant differences between the two groups were found with regards to intraoperative characteristics or the type of surgery. However, compared to 2022, there was a 233% increase in the number of transplantations in the 2023 cohort (p-value 0.24). Patient outcomes during wartime were similar to those of 2022, including postoperative complications, length of stay, and mortality.
Patients who underwent cardiac surgery during wartime presented with comparable outcomes when compared to those of last year despite the increase in cardiac surgery workload. There was an increase in the number of transplants this year, attributed to the unfortunate increase in organ donors.
2023 年 10 月 7 日开始的战争影响了以色列所有主要的三级医疗中心。在以色列最大的心脏外科部门，尽管有约 50%的外科医生被征召入伍服兵役，但心脏直视手术的数量却出人意料地增加了。本研究的目的是描述战时手术数量的增加，并评估国家危机是否影响了患者的预后。
该研究基于 2023 年 10 月 7 日至 12 月 7 日战争头两个月期间接受心脏手术或体外膜肺氧合（ECMO）的 275 例患者的前瞻性登记，以及 2022 年同期接受心脏手术的患者（2022 年 10 月 7 日-12 月 7 日）。
2022 年有 120 例患者（43.6%）接受了手术，2023 年有 155 例（56.4%）。这意味着心脏直视手术增加了 33.0%（2022 年 109 例，2023 年 145 例，p 值 0.26）。与 2022 年患者相比，2023 年患者的基线特征无显著差异。两组患者术中特征或手术类型无显著差异。然而，与 2022 年相比，2023 年移植手术数量增加了 233%（p 值 0.24）。战争期间患者的预后与 2022 年相似，包括术后并发症、住院时间和死亡率。
尽管心脏手术工作量增加，但战争期间接受心脏手术的患者的预后与去年相似。今年移植手术数量增加，这归因于器官捐献者的不幸增加。
