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Cardiovascular procedural deferral and outcomes over COVID-19 pandemic phases: A multi-center study

Celina M Yong1, Kateri J Spinelli2, Shih Ting Chiu2

  • 1Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA; Department of Medicine, Stanford University School of Medicine, and Stanford Cardiovascular Institute, Stanford, CA.

American Heart Journal
|June 28, 2021
PubMed

Insights

The COVID-19 pandemic led to significant drops in cardiovascular procedures, disproportionately affecting women, older adults, and minority groups. However, in-hospital mortality rates remained unchanged.

Area of Science:

  • Cardiology
  • Public Health
  • Healthcare Management

Background:

  • The COVID-19 pandemic significantly disrupted routine cardiovascular care globally.
  • The impact of these disruptions on procedural deferrals and patient outcomes remains unclear across diverse populations.

Purpose of the Study:

  • To analyze changes in cardiovascular procedure volumes during the COVID-19 pandemic.
  • To assess the impact of the pandemic on patient demographics and procedural acuity.
  • To compare in-hospital mortality rates before and during the pandemic.

Main Methods:

  • Analysis of 36,125 cardiovascular procedures (PCI, CABG, TAVR, SAVR) from December 2018 to June 2020 across 30 hospitals in 2 healthcare systems.
  • Comparison of procedural volumes and patient characteristics across pre-COVID, COVID I (March 15-April 11, 2020), and COVID II (April 12, 2020 onwards) phases.
  • Risk-adjusted in-hospital mortality assessed using multivariate logistic regression.

Main Results:

  • Weekly procedural volumes significantly decreased during COVID I, followed by a recovery phase (COVID II).
  • Patients undergoing procedures during COVID I were less likely to be female, older, Asian or Black, or Medicare insured, but procedures were of higher acuity.
  • No significant differences in risk-adjusted in-hospital mortality were observed during COVID I or COVID II compared to pre-COVID levels.

Conclusions:

  • The COVID-19 pandemic caused significant reductions in cardiovascular procedural volumes early on.
  • These reductions disproportionately impacted specific demographic groups, including by race, gender, and age.
  • Findings underscore the need for strategies to mitigate healthcare disruptions and ensure equitable care during future public health crises.
Abstract

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