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Consequences of canceling elective invasive cardiac procedures during Covid‐19 outbreak

2020; Wiley; Volume: 97; Issue: 5 Linguagem: Inglês

10.1002/ccd.29433

1522-726X

Raúl Moreno, José‐Luis Díez, José‐Antonio Diarte, Fernando Macaya, José‐María de la Torrre Hernández, Oriol Rodríguez‐Leor, Ramiro Trillo, Juan H. Alonso‐Briales, Ignacio J. Amat‐Santos, Rafael Romaguera, José‐Francisco Díaz, Beatriz Vaquerizo, Soledad Ojeda, Ignacio Cruz‐González, Daniel Morena‐Salas, Armando Pérez de Prado, Fernando Sarnago, Pilar Portero, Alejandro Gutiérrez, Fernándo Alfonso, Eduard Bosch, Eduardo Pinar, José‐Ramón Ruiz‐Arroyo, Valeriano Ruiz‐Quevedo, Jesús Jiménez‐Mazuecos, Fernando Lozano, José Ramón Rumoroso, Enrique Novo, Francisco Javier Irazusta, Bruno García del Blanco, José Moreu, Sara Ballesteros-Pradas, Araceli Frutos, Manuel Villa, Eduardo Alegría‐Barrero, Rosa Lázaro, Emilio Paredes-Galán,

Cardiac, Anesthesia and Surgical Outcomes

Abstract Background During COVID‐19 pandemic in Spain, elective procedures were canceled or postponed, mainly due to health care systems overwhelming. Objective The objective of this study was to evaluate the consequences of interrupting invasive procedures in patients with chronic cardiac diseases due to the COVID‐19 outbreak in Spain. Methods The study population is comprised of 2,158 patients that were pending on elective cardiac invasive procedures in 37 hospitals in Spain on the 14th of March 2020, when a state of alarm and subsequent lockdown was declared in Spain due to the COVID‐19 pandemic. These patients were followed‐up until April 31th. Results Out of the 2,158 patients, 36 (1.7%) died. Mortality was significantly higher in patients pending on structural procedures (4.5% vs. 0.8%, respectively; p < .001), in those >80 year‐old (5.1% vs. 0.7%, p < .001), and in presence of diabetes (2.7% vs. 0.9%, p = .001), hypertension (2.0% vs. 0.6%, p = .014), hypercholesterolemia (2.0% vs. 0.9%, p = .026) [Correction added on December 23, 2020, after first online publication: as per Dr. Moreno's request changes in p‐values were made after original publication in Abstract.], chronic renal failure (6.0% vs. 1.2%, p < .001), NYHA > II (3.8% vs. 1.2%, p = .001), and CCS > II (4.2% vs. 1.4%, p = .013), whereas was it was significantly lower in smokers (0.5% vs. 1.9%, p = .013). Multivariable analysis identified age > 80, diabetes, renal failure and CCS > II as independent predictors for mortality. Conclusion Mortality at 45 days during COVID‐19 outbreak in patients with chronic cardiovascular diseases included in a waiting list due to cancellation of invasive elective procedures was 1.7%. Some clinical characteristics may be of help in patient selection for being promptly treated when similar situations happen in the future.