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10.1016/j.ahj.2021.06.011

http://scihub22266oqcxt.onion/10.1016/j.ahj.2021.06.011
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suck abstract from ncbi


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pmid34181910      Am+Heart+J 2021 ; 241 (ä): 14-25
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  • Cardiovascular procedural deferral and outcomes over COVID-19 pandemic phases: A multi-center study #MMPMID34181910
  • Yong CM; Spinelli KJ; Chiu ST; Jones B; Penny B; Gummidipundi S; Beach S; Perino A; Turakhia M; Heidenreich P; Gluckman TJ
  • Am Heart J 2021[Nov]; 241 (ä): 14-25 PMID34181910show ga
  • BACKGROUND: The COVID-19 pandemic has disrupted routine cardiovascular care, with unclear impact on procedural deferrals and associated outcomes across diverse patient populations. METHODS: Cardiovascular procedures performed at 30 hospitals across 6 Western states in 2 large, non-profit healthcare systems (Providence St. Joseph Health and Stanford Healthcare) from December 2018-June 2020 were analyzed for changes over time. Risk-adjusted in-hospital mortality was compared across pandemic phases with multivariate logistic regression. RESULTS: Among 36,125 procedures (69% percutaneous coronary intervention, 13% coronary artery bypass graft surgery, 10% transcatheter aortic valve replacement, and 8% surgical aortic valve replacement), weekly volumes changed in 2 distinct phases after the initial inflection point on February 23, 2020: an initial period of significant deferral (COVID I: March 15-April 11) followed by recovery (COVID II: April 12 onwards). Compared to pre-COVID, COVID I patients were less likely to be female (P = .0003), older (P < .0001), Asian or Black (P = .02), or Medicare insured (P < .0001), and COVID I procedures were higher acuity (P < .0001), but not higher complexity. In COVID II, there was a trend toward more procedural deferral in regions with a higher COVID-19 burden (P = .05). Compared to pre-COVID, there were no differences in risk-adjusted in-hospital mortality during both COVID phases. CONCLUSIONS: Significant decreases in cardiovascular procedural volumes occurred early in the COVID-19 pandemic, with disproportionate impacts by race, gender, and age. These findings should inform our approach to future healthcare disruptions.
  • |*Hospital Mortality[MESH]
  • |Aged[MESH]
  • |Aortic Valve Disease/*surgery[MESH]
  • |Asian[MESH]
  • |Black or African American[MESH]
  • |COVID-19/*epidemiology[MESH]
  • |Coronary Artery Bypass/*statistics & numerical data[MESH]
  • |Coronary Artery Disease/*surgery[MESH]
  • |Female[MESH]
  • |Heart Valve Prosthesis Implantation/statistics & numerical data[MESH]
  • |Humans[MESH]
  • |Logistic Models[MESH]
  • |Male[MESH]
  • |Medicare[MESH]
  • |Middle Aged[MESH]
  • |Percutaneous Coronary Intervention/*statistics & numerical data[MESH]
  • |SARS-CoV-2[MESH]
  • |Sex Factors[MESH]
  • |Time-to-Treatment/*statistics & numerical data[MESH]
  • |Transcatheter Aortic Valve Replacement/*statistics & numerical data[MESH]


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