冠状动脉绕道移植后COVID-19感染与术后结果之间的关联:回顾性队列研究
Henry Hoang1, Erik Romanelli1, Felix Borngaesser1
1Department of Anesthesiology, Montefiore Medical Center, Bronx, NY.
Journal of cardiothoracic and vascular anesthesia
|August 22, 2025
概括
在冠状动脉旁路移植 (CABG) 手术前两周内最近感染COVID-19 会显著增加严重并发症和死亡的风险. 由于风险增加,患者需要仔细考虑.
科学领域:
- 心脏病学
- 传染性疾病
- 公共卫生
背景情况:
- 在全球范围内,COVID-19疫情已经影响了外科护理.
- 了解与手术前感染相关的风险对于患者的安全至关重要.
研究的目的:
- 在接受冠状动脉旁路移植 (CABG) 的患者中,评估2019年冠状动脉疾病 (COVID-19) 感染和术后并发症的时间之间的关联.
主要方法:
- 一项回顾性队列研究利用了国家COVID队列协作 (N3C) 数据库.
- 接受CABG的成年患者根据COVID-19感染时间进行分层:手术前0至2周,2至6周和6至12周.
- 结果包括静脉血栓塞,败血症,急性损伤和死亡率,在COVID-19阳性和COVID-19阴性组之间进行了比较.
主要成果:
- 在CABG前0-2周内感染COVID-19与静脉血栓栓塞 (OR2.29),败血症 (OR1.74),30天死亡率 (OR3.60) 和1年死亡率 (OR3.10) 的几率显著增加有关.
- 在手术前期没有发现手术部位感染或急性心肌梗塞的显著关联.
- 与CABG手术相关的COVID-19感染时间是影响术后结果的关键因素.
结论:
- 在CABG手术后两周内进行手术前的COVID-19感染大大增加了严重并发症和死亡的风险.
- 需要进一步研究底层机制.
- 优化手术前护理策略对于接受CABG的近期COVID-19感染患者至关重要.
相关概念视频
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
27
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
27
01:23Peripheral Artery Disease V: Postoperative Nursing Management
25
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
25
01:27Coronary Artery Disease V: Interprofessional Care
30
Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
30
01:30Acute Coronary Syndrome III: Diagnostic Studies
23
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
23
01:26Coronary Artery Disease II: Pathophysiology
34
Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
34
01:26Factors Affecting the Risk of Infection
12.3K
The hosts' susceptibility to infection depends on several factors. The integrity of the skin and mucous membranes helps protect the body against microbial attacks. When the skin is altered, the chance of infection, limb loss, and even death increases.
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
12.3K