Englbrecht Jan S, Landwehrt Jan K, Welp Henryk, Martens Sven, Gottschalk Antje
Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, 48149, Münster, Germany.
Department of Cardiothoracic Surgery, University Hospital Münster, Münster, Germany.
J Cardiothorac Surg. 2025 Feb 15;20(1):130. doi: 10.1186/s13019-025-03373-2.
Studies show conflicting results regarding the impact of the COVID-19 pandemic on the treatment of patients with coronary artery disease requiring cardiac surgery and data from Germany are lacking. In this study, two patient cohorts who underwent coronary artery bypass graft surgery before and after the start of the COVID-19 pandemic were compared.
Patients who presented for coronary artery bypass graft surgery before (01.05.18-30.04.19; group "B") or during the COVID-19 pandemic (01.05.20-30.04.21; group "P") at the University Hospital Münster in Germany were retrospectively identified and compared regarding demographics, preoperative status, surgical data, and postoperative outcome.
513 (group "B") and 501 patients (group "P") were included, demographics were comparable. In group "P", preoperative myocardial infarction and emergency indications were more frequent, heart-lung machine and aortic clamping times were longer. Postoperative ICU-days and inpatient stay did not differ. Postoperative need of an extracorporeal life support system and intrahospital mortality tended to be higher in group "P", without reaching statistical significance.
The COVID-19 pandemic had a significant impact on cardiac surgical care with the prioritization of emergency procedures. Patients treated during the pandemic were in a more critical preoperative condition, duration of surgery was longer, but post-operative mortality was comparable.
关于新冠疫情对需要心脏手术的冠心病患者治疗的影响,研究结果相互矛盾,且缺乏来自德国的数据。在本研究中,对新冠疫情开始之前和之后接受冠状动脉旁路移植手术的两组患者进行了比较。
回顾性确定在德国明斯特大学医院于新冠疫情之前(2018年5月1日至2019年4月30日;“B”组)或期间(2020年5月1日至2021年4月30日;“P”组)接受冠状动脉旁路移植手术的患者,并就人口统计学、术前状况、手术数据和术后结果进行比较。
纳入513例(“B”组)和501例患者(“P”组),人口统计学特征具有可比性。在“P”组中,术前心肌梗死和急诊指征更为常见,体外循环和主动脉阻断时间更长。术后重症监护病房住院天数和住院时间无差异。“P”组术后对体外生命支持系统的需求和院内死亡率有升高趋势,但未达到统计学意义。
新冠疫情对心脏外科护理产生了重大影响,急诊手术被优先考虑。疫情期间接受治疗的患者术前状况更为危急,手术时间更长,但术后死亡率相当。