Coronary Artery Bypass Graft Surgery Outcomes in the United States: Impact of COVID-19 Pandemic

Parcha, Vibhu; Kalra, Rajat; Glenn, Austin M.; Davies, James E.; Kuranz, Seth; Arora, Garima; Arora, Pankaj

Objective There has been a substantial decline in patients presenting for emergent and routine cardiovascular care in the United States after the onset of the coronavirus disease-2019 (COVID-19) pandemic. We sought to assess the risk of adverse clinical outcomes among patients undergoing coronary artery bypass graft (CABG) surgery during the 2020 COVID-19 pandemic period and compare the risks to those undergoing CABG prior to the pandemic in the year 2019. Methods A retrospective cross-sectional analysis of the TriNetX Research Network database was performed. Patients undergoing CABG between January 20, 2019, and September 15, 2019, contributed to the 2019 cohort, and those undergoing CABG between January 20, 2020, and September 15, 2020, contributed to the 2020 cohort. Propensity-score matching was performed, and the odds of mortality, acute kidney injury (AKI), stroke, acute respiratory distress syndrome (ARDS), and mechanical ventilation occurring by 30-days were evaluated. Results The number of patients undergoing CABG in 2020 declined by 35.5% from 5,534 patients in 2019 to 3,569 patients in 2020. After propensity-score matching, 3,569 patient pairs were identified in the 2019 and the 2020 cohorts. Compared with those undergoing CABG in 2019, the odds of mortality by 30-days were 0.96 (95%CI:0.69-1.33;p=0.80) in those undergoing CABG in 2020. The odds for stroke (OR:1.21 [95%CI:0.96-1.39]), AKI (OR: 0.76 [95%CI:0.59-1.08]), ARDS (OR:1.01 [95%CI:0.60-2.42]) and mechanical ventilation (OR: 1.11 [95% CI: 0.94-1.30]) were similar between the two cohorts. Conclusions The number of patients undergoing CABG in 2020 has substantially declined compared to 2019. Similar odds of adverse clinical outcomes was seen among patients undergoing CABG in the setting of COVID-19 compared with those in 2019.