Wu Ling, Lin Pei-Shuang, Yao Yun-Tai
Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical University, 230022 Hefei, Anhui, China.
Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, 100037 Beijing, China.
Rev Cardiovasc Med. 2024 Dec 24;25(12):456. doi: 10.31083/j.rcm2512456. eCollection 2024 Dec.
The impact of seasonal patterns on the mortality and morbidity of surgical patients with cardiovascular diseases has gained increasing attention in recent years. However, whether this seasonal variation extends to cardiovascular surgery outcomes remains unknown. This study sought to evaluate the effects of seasonal variation on the short-term outcomes of patients undergoing off-pump coronary artery bypass grafting (OPCABG).
This study identified all patients undergoing elective OPCABG at a single cardiovascular center between January 2020 and December 2020. Patients were divided into four groups according to the season of their surgery. The primary outcome was the composite incidence of mortality and morbidity during hospitalization. Secondary outcomes included chest tube drainage (CTD) within 24 h, total CTD, chest drainage duration, mechanical ventilation duration, and postoperative length of stay (LOS) in the intensive care unit (ICU) and hospital.
Winter and spring surgeries were associated with higher composite incidence of mortality and morbidities (26.8% and 18.0%) compared to summer (15.7%) and autumn (11.1%) surgeries ( < 0.05). Spring surgery had the highest median CTD within 24 hours after surgery (640 mL), whereas it also exhibited the lowest total CTD (730 mL) ( < 0.05). Chest drainage duration was longer in spring and summer than in autumn and winter ( < 0.05). While no significant differences were observed in mechanical ventilation duration and hospital stay among the four seasons, the LOS in the ICU was longer in summer than in autumn (88 h 51 h, < 0.05).
The OPCABG outcomes might exhibit seasonal patterns in patients with coronary heart disease.
近年来，季节模式对心血管疾病外科患者死亡率和发病率的影响日益受到关注。然而，这种季节变化是否会延伸至心血管手术结果仍不清楚。本研究旨在评估季节变化对非体外循环冠状动脉旁路移植术（OPCABG）患者短期结局的影响。
本研究纳入了2020年1月至2020年12月期间在单一心血管中心接受择期OPCABG的所有患者。根据手术季节将患者分为四组。主要结局是住院期间死亡率和发病率的综合发生率。次要结局包括术后24小时内胸腔闭式引流量（CTD）、总CTD、胸腔引流持续时间、机械通气持续时间以及重症监护病房（ICU）和医院的术后住院时间（LOS）。
与夏季（15.7%）和秋季（11.1%）手术相比，冬季和春季手术的死亡率和发病率综合发生率更高（分别为26.8%和18.0%）（P<0.05）。春季手术术后24小时内的CTD中位数最高（640 mL），而其总CTD也最低（730 mL）（P<0.05）。春季和夏季的胸腔引流持续时间比秋季和冬季更长（P<0.05）。虽然四个季节的机械通气持续时间和住院时间没有显著差异，但夏季在ICU的住院时间比秋季更长（88小时对51小时，P<0.05）。
冠心病患者的OPCABG结局可能呈现季节性模式。
