Tabowei Godfrey, Garza John, Fath Ayman, Sukhera Ahmed Bashir, Ogedegbe Oboseh John, Alugba Gabriel, Dadzie Samuel, Fasola Ooreoluwa, Tesfaye Meron, Enakpene Evbu, Prasad Anand
Department of Internal Medicine, Texas Tech University Health Sciences Center Permian Basin, Odessa, Texas.
Texas Tech University Health Sciences Center School of Medicine - Permian Basin, Odessa, Texas.
J Soc Cardiovasc Angiogr Interv. 2025 May 13;4(8):103605. doi: 10.1016/j.jscai.2025.103605. eCollection 2025 Aug.
COVID-19 is associated with a higher burden of cardiovascular morbidity and mortality. The association of COVID-19 and mortality in hospitalizations with coronary artery bypass graft (CABG) has not been determined.
We conducted a population-based cohort study of the association of COVID-19 and mortality in hospitalizations with CABG using the Texas Inpatient Public Use Data File over the period Q2 2020 through Q4 2023. The primary exposure was a diagnosis of COVID-19, and the primary outcome was in-hospital mortality. Short-term mortality and total length of stay were used as secondary outcomes. The primary analysis approach was overlapping propensity score weighting with treatment weighting and inverse probability of treatment weighting applied as alternative analyses. Results are reported as adjusted risk ratio (aRR) and 95% CI. The adjusted risk difference and 95% CI are provided as an alternative effect size measure.
A total of 47,501 hospitalizations with a procedure code for CABG were identified, of which 509 (1.1%) had COVID-19. CABG hospitalizations with vs without COVID-19 had higher comorbidity index (2.01 ± 1.65 vs 1.65 ± 1.61), more frequent need for invasive mechanical ventilation (12.8% vs 8.5%), had higher rates of myocardial infarction (65.0% vs 45.6%), higher rates of congestive heart failure (53.4% vs 40.1%), and higher rates of acute kidney injury (35.6% vs 24.3%); < .0001 for each comparison. CABG hospitalizations with COVID-19 had higher unadjusted in-hospital mortality (6.3% vs 2.2%) and unadjusted length of stay (16.2 ± 11.6 days vs 9.6 ± 6.8 days), compared with those without COVID-19. In adjusted analysis, COVID-19 was associated with a 53.9% increase in the risk of in-hospital mortality (aRR, 1.5394; 95% CI, 1.0836 to 2.1870) and a 40.3% increase in length of stay aRR 1.4028 (95% CI, 1.3138 to 1.4978).
COVID-19 was strongly associated with increased mortality in hospitalizations with CABG during the pandemic. The association weakened year over year and by 2023 was no longer present. COVID-19 has remained strongly associated with increased length of stay in hospitalizations with CABG including after the conclusion of the pandemic.
2019冠状病毒病（COVID-19）与心血管疾病更高的发病和死亡负担相关。COVID-19与冠状动脉旁路移植术（CABG）住院患者死亡率之间的关联尚未确定。
我们利用2020年第二季度至2023年第四季度的德克萨斯州住院患者公共使用数据文件，进行了一项基于人群的队列研究，以探讨COVID-19与CABG住院患者死亡率之间的关联。主要暴露因素为COVID-19诊断，主要结局为住院死亡率。短期死亡率和总住院时长用作次要结局。主要分析方法为重叠倾向评分加权，并将治疗加权和治疗逆概率加权用作替代分析。结果以调整风险比（aRR）和95%置信区间（CI）报告。调整风险差和95%CI作为替代效应量指标提供。
共识别出47,501例有CABG手术编码的住院患者，其中509例（1.1%）患有COVID-19。患有COVID-19的CABG住院患者与未患COVID-19的患者相比，合并症指数更高（2.01±1.65对1.65±1.61），有创机械通气需求更频繁（12.8%对8.5%），心肌梗死发生率更高（65.0%对45.6%），充血性心力衰竭发生率更高（53.4%对40.1%），急性肾损伤发生率更高（35.6%对24.3%）；每项比较均P<0.0001。与未患COVID-19的患者相比，患有COVID-19的CABG住院患者未经调整的住院死亡率更高（6.3%对2.2%），未经调整的住院时长更长（16.2±11.6天对9.6±6.8天）。在调整分析中，COVID-19与住院死亡率风险增加53.9%相关（aRR，1.5394；95%CI，1.0836至2.1870），住院时长增加40.3%相关（aRR 1.4028，95%CI，1.3138至1.4978）。
在疫情期间，COVID-19与CABG住院患者死亡率增加密切相关。这种关联逐年减弱，到2023年已不再存在。COVID-19与CABG住院患者住院时长增加仍然密切相关，包括在疫情结束后。
