The results of cardiac surgery during the COVID-19 pandemic compared with previous years: a propensity weighted study of outcomes at six months

Emily Day; Francesca Fiorentino; Mohamed Abdelkhalek; Hassiba Smail; Ulrich A. Stock; Sunil Bhudia; Fabio De Robertis; Toufan Bahrami; Shahzad Raja; Jullien Gaer

doi:10.1177/01410768221077357

The results of cardiac surgery during the COVID-19 pandemic compared with previous years: a propensity weighted study of outcomes at six months

Emily Day, Francesca Fiorentino, Mohamed Abdelkhalek, Hassiba Smail, Ulrich A. Stock, Sunil Bhudia, Fabio De Robertis, Toufan Bahrami, Shahzad Raja, Jullien Gaer^*

^*Corresponding author for this work

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Abstract

Objectives: In addition to excess mortality due to COVID-19, the pandemic has been characterised by excess mortality due to non-COVID diagnoses and consistent reports of patients delaying seeking medical treatment. This study seeks to compare the outcomes of cardiac surgery during and before the COVID-19 pandemic. Design: Our institutional database was interrogated retrospectively to identify all patients undergoing one of three index procedures during the first six months of the pandemic and the corresponding epochs of the previous five years. Setting: A regional cardiothoracic centre. Participants: All patients undergoing surgery during weeks #13-37, 2015-2020. Main outcome measures: Propensity score weighted analysis was employed to compare the incidence of major complications (stroke, renal failure, re-ventilation), 30-day mortality, six month survival and length of hospital stay between the two groups. Results: There was no difference in 30-day mortality (HR = 0.76 [95% CI 0.27-2.20], p = 0.6211), 6-month survival (HR = 0.94 [95% CI 0.44-2.01], p = 0.8809) and duration of stay (SHR = 1.00 (95% CI 0.90-1.12), p = 0.959) between the two eras. There were no differences in the incidence of major complications (weighted chi-square test: renal failure: p = 0.923, stroke: p = 0.991, new respiratory failure: p = 0.856). Conclusions: Cardiac surgery is as safe now as in the previous five years. Concerns over the transmission of COVID-19 in hospital are understandable but patients should be encouraged not to delay seeking medical attention. All involved in healthcare and the wider public should be reassured by these findings.

Original language	English
Pages (from-to)	341-347
Number of pages	7
Journal	Journal of the Royal Society of Medicine
Volume	115
Issue number	9
Early online date	7 Feb 2022
DOIs	https://doi.org/10.1177/01410768221077357
Publication status	Published - Sept 2022

Keywords

cardiac surgical procedures
COVID-19
health resources
length of stay

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10.1177/01410768221077357

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Day, E., Fiorentino, F., Abdelkhalek, M., Smail, H., Stock, U. A., Bhudia, S., De Robertis, F., Bahrami, T., Raja, S., & Gaer, J. (2022). The results of cardiac surgery during the COVID-19 pandemic compared with previous years: a propensity weighted study of outcomes at six months. Journal of the Royal Society of Medicine, 115(9), 341-347. https://doi.org/10.1177/01410768221077357

@article{0d6c698c51a14ef4933446d0b9f427c6,

title = "The results of cardiac surgery during the COVID-19 pandemic compared with previous years: a propensity weighted study of outcomes at six months",

abstract = "Objectives: In addition to excess mortality due to COVID-19, the pandemic has been characterised by excess mortality due to non-COVID diagnoses and consistent reports of patients delaying seeking medical treatment. This study seeks to compare the outcomes of cardiac surgery during and before the COVID-19 pandemic. Design: Our institutional database was interrogated retrospectively to identify all patients undergoing one of three index procedures during the first six months of the pandemic and the corresponding epochs of the previous five years. Setting: A regional cardiothoracic centre. Participants: All patients undergoing surgery during weeks #13-37, 2015-2020. Main outcome measures: Propensity score weighted analysis was employed to compare the incidence of major complications (stroke, renal failure, re-ventilation), 30-day mortality, six month survival and length of hospital stay between the two groups. Results: There was no difference in 30-day mortality (HR = 0.76 [95% CI 0.27-2.20], p = 0.6211), 6-month survival (HR = 0.94 [95% CI 0.44-2.01], p = 0.8809) and duration of stay (SHR = 1.00 (95% CI 0.90-1.12), p = 0.959) between the two eras. There were no differences in the incidence of major complications (weighted chi-square test: renal failure: p = 0.923, stroke: p = 0.991, new respiratory failure: p = 0.856). Conclusions: Cardiac surgery is as safe now as in the previous five years. Concerns over the transmission of COVID-19 in hospital are understandable but patients should be encouraged not to delay seeking medical attention. All involved in healthcare and the wider public should be reassured by these findings.",

keywords = "cardiac surgical procedures, COVID-19, health resources, length of stay",

author = "Emily Day and Francesca Fiorentino and Mohamed Abdelkhalek and Hassiba Smail and Stock, {Ulrich A.} and Sunil Bhudia and {De Robertis}, Fabio and Toufan Bahrami and Shahzad Raja and Jullien Gaer",

note = "Publisher Copyright: {\textcopyright} 2022, The Royal Society of Medicine.",

year = "2022",

month = sep,

doi = "10.1177/01410768221077357",

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Day, E, Fiorentino, F, Abdelkhalek, M, Smail, H, Stock, UA, Bhudia, S, De Robertis, F, Bahrami, T, Raja, S & Gaer, J 2022, 'The results of cardiac surgery during the COVID-19 pandemic compared with previous years: a propensity weighted study of outcomes at six months', Journal of the Royal Society of Medicine, vol. 115, no. 9, pp. 341-347. https://doi.org/10.1177/01410768221077357

TY - JOUR

T1 - The results of cardiac surgery during the COVID-19 pandemic compared with previous years

T2 - a propensity weighted study of outcomes at six months

AU - Day, Emily

AU - Fiorentino, Francesca

AU - Abdelkhalek, Mohamed

AU - Smail, Hassiba

AU - Stock, Ulrich A.

AU - Bhudia, Sunil

AU - De Robertis, Fabio

AU - Bahrami, Toufan

AU - Raja, Shahzad

AU - Gaer, Jullien

PY - 2022/9

Y1 - 2022/9

N2 - Objectives: In addition to excess mortality due to COVID-19, the pandemic has been characterised by excess mortality due to non-COVID diagnoses and consistent reports of patients delaying seeking medical treatment. This study seeks to compare the outcomes of cardiac surgery during and before the COVID-19 pandemic. Design: Our institutional database was interrogated retrospectively to identify all patients undergoing one of three index procedures during the first six months of the pandemic and the corresponding epochs of the previous five years. Setting: A regional cardiothoracic centre. Participants: All patients undergoing surgery during weeks #13-37, 2015-2020. Main outcome measures: Propensity score weighted analysis was employed to compare the incidence of major complications (stroke, renal failure, re-ventilation), 30-day mortality, six month survival and length of hospital stay between the two groups. Results: There was no difference in 30-day mortality (HR = 0.76 [95% CI 0.27-2.20], p = 0.6211), 6-month survival (HR = 0.94 [95% CI 0.44-2.01], p = 0.8809) and duration of stay (SHR = 1.00 (95% CI 0.90-1.12), p = 0.959) between the two eras. There were no differences in the incidence of major complications (weighted chi-square test: renal failure: p = 0.923, stroke: p = 0.991, new respiratory failure: p = 0.856). Conclusions: Cardiac surgery is as safe now as in the previous five years. Concerns over the transmission of COVID-19 in hospital are understandable but patients should be encouraged not to delay seeking medical attention. All involved in healthcare and the wider public should be reassured by these findings.

AB - Objectives: In addition to excess mortality due to COVID-19, the pandemic has been characterised by excess mortality due to non-COVID diagnoses and consistent reports of patients delaying seeking medical treatment. This study seeks to compare the outcomes of cardiac surgery during and before the COVID-19 pandemic. Design: Our institutional database was interrogated retrospectively to identify all patients undergoing one of three index procedures during the first six months of the pandemic and the corresponding epochs of the previous five years. Setting: A regional cardiothoracic centre. Participants: All patients undergoing surgery during weeks #13-37, 2015-2020. Main outcome measures: Propensity score weighted analysis was employed to compare the incidence of major complications (stroke, renal failure, re-ventilation), 30-day mortality, six month survival and length of hospital stay between the two groups. Results: There was no difference in 30-day mortality (HR = 0.76 [95% CI 0.27-2.20], p = 0.6211), 6-month survival (HR = 0.94 [95% CI 0.44-2.01], p = 0.8809) and duration of stay (SHR = 1.00 (95% CI 0.90-1.12), p = 0.959) between the two eras. There were no differences in the incidence of major complications (weighted chi-square test: renal failure: p = 0.923, stroke: p = 0.991, new respiratory failure: p = 0.856). Conclusions: Cardiac surgery is as safe now as in the previous five years. Concerns over the transmission of COVID-19 in hospital are understandable but patients should be encouraged not to delay seeking medical attention. All involved in healthcare and the wider public should be reassured by these findings.

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KW - COVID-19

KW - health resources

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ER -

The results of cardiac surgery during the COVID-19 pandemic compared with previous years: a propensity weighted study of outcomes at six months

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