(Press-News.org) CHICAGO (January 30, 2021) -- The most deadly global health crisis in a century has resulted in a substantial decline in overall heart surgery volume and an unexplained increase in deaths after coronary artery bypass grafting, according to late-breaking research presented at the 57th Annual Meeting of The Society of Thoracic Surgeons.
"This study was a true herculean analysis and tour de force that showed the COVID effect on adult cardiac surgery volume, trends, and outcomes," said Tom C. Nguyen, MD, from the University of California San Francisco. "The pandemic has changed the world as we know it, causing a dramatic drop in adult cardiac surgery volume and worsening patient outcomes."
Dr. Nguyen and colleagues queried the STS Adult Cardiac Surgery Database from January 1, 2018, to June 30, 2020, and The Johns Hopkins COVID-19 Dashboard from February 1, 2020, to January 1, 2021. The researchers examined data from 717,103 adult cardiac surgery patients and more than 20 million COVID-19 patients in an effort to determine how the pandemic affected adult cardiac surgery on national and regional levels.
"Only the STS National Database has the level of granularity, COVID variables, and longitudinal follow-up to answer the questions posed in this important study," said Dr. Nguyen. "Our research also analyzed data by regions to get an idea of how specific areas did during the COVID pandemic."
According to the study results, there was a 53% decrease nationwide in all adult cardiac surgery volume when compared to 2019 and 65% fewer elective cases in the United States. COVID also impacted non-elective cases, resulting in a 40% decrease.
In addition, the data showed that no matter the procedure--isolated coronary artery bypass grafting (CABG), isolated aortic valve replacement (AVR), isolated mitral valve replacement (MVR), CABG+AVR, CABG+MVR, isolated MV repair, and CABG+MV repair--there was a significant decline in case volume--54%--when compared to 2019.
Regionally, the Mid-Atlantic area (New York, New Jersey, and Pennsylvania), was among those most affected by the COVID crisis, experiencing a 71% decrease in overall case volume, 75% fewer elective cases, and a 59% reduction in non-elective cases. Another hotspot, the New England region (Maine, Vermont, New Hampshire, Massachusetts, Connecticut and Rhode Island), showed a 63% reduction in overall case volume.
The researchers also found that prior to the COVID surge, the Mid-Atlantic and New England regions had excellent outcomes with an observed-to-expected (O/E) ratio of less than 1, which represents a better-than-expected mortality rate. However, during the COVID surge, there was a 110% increase in the O/E for all adult cardiac procedures and a 167% increase for isolated CABG, meaning more patients were dying than expected.
Though the data did not directly address the cause of increased mortality, many surgeons say they currently are limited to operating on only the most urgent coronary bypass cases and patients who tend to be sicker. "These numbers should not serve as a deterrent to patients seeking care for chest pain or other cardiac symptoms," said Robbin G. Cohen, MD, MMM, from Keck School of Medicine of the University of Southern California in Los Angeles, who was not directly involved with this study. "If anything, they are a warning to get into the system as soon as possible."
At the time of presentation, there were 95.4 million global cases of COVID-19 with more than 2 million global deaths. The US accounted for more than 24 million cases and approximately 400,000 deaths.
In the past year, this crisis has altered or halted virtually every aspect of society, and the practice of cardiothoracic surgery clearly has not been immune. The abrupt cessation of surgery in mid-March 2020 has proven to have had far-reaching implications, as the negative effects of canceled and postponed procedures on patient health outcomes now are being realized.
"We clearly demonstrated that if you have heart surgery during COVID, you have an increased risk of morbidity and mortality," said Dr. Nguyen. "No doubt that COVID hit us hard."
According to Dr. Nguyen, this study is only the first of many more "granular" analyses to come. The researchers plan to examine trends and outcomes of COVID patients vs. non-COVID patients, as well as delve more into the COVID effect on specific adult cardiac procedures such as aortic dissections.
INFORMATION:
For more information, contact Jennifer Bagley, Senior Manager of Media Relations, at 312-202-5865 or jbagley@sts.org.
Founded in 1964, The Society of Thoracic Surgeons is a not-for-profit organization representing more than 7,500 cardiothoracic surgeons, researchers, and allied health care professionals worldwide who are dedicated to ensuring the best possible outcomes for surgeries of the heart, lung, and esophagus, as well as other surgical procedures within the chest. The Society's mission is to advance cardiothoracic surgeons' delivery of the highest quality patient care through collaboration, education, research, and advocacy.
(Singapore--January 30, 2021 11:00 p.m. SPT/January 30, 2021 10:00 a.m. EST)-- Nivolumab monotherapy is an effective treatment option for relapsed malignant mesothelioma (MM), according to research presented today at the International Association for the Study of Lung Cancer World Conference on Lung Cancer.
Malignant mesothelioma is an intractable cancer, and no phase III trial has yet shown an improvement in overall survival following the standard first line chemotherapy doublet comprising pemetrexed and cisplatin or carboplatin since it was licensed in 2004.
Professor Dean Fennell, chair of Thoracic Medical Oncology at the University of Leicester in collaboration with Professor Gareth Griffiths and his team at the Southampton Clinical Trials Unit, University of Southampton, ...
(Singapore--January 30, 2021 11:00 p.m. SPT/January 30, 2021 10:00 a.m. EST)-- A phase III study examining whether messenger (m)RNA expression correlated with sensitivity or resistance to chemotherapy did not confer a statistically significant advantage in overall survival for patients with resected stage II-III non-small cell lung cancer (NSCLC), according to research presented at the International Association for the Study of Lung Cancer World Conference on Lung Cancer.
Lung cancer researchers and clinicians have sought methods to improve chemotherapy's modest 5% overall survival rate for patients with NSCLC. Dr. Silvia Novello, professor of medical oncology at the University of Torino at ...
(Singapore--January 30, 2021 11:00 p.m. SPT/January 30, 2021 10:00 a.m. EST)-- Primary analysis of the Lung Cancer Mutation Consortium (LCMC) 3 study revealed that neoadjuvant atezolizumab prior to lung cancer surgery was well tolerated by patients and met its primary endpoint of 20% major pathologic response rate, according to research presented today at the International Association for the Study of Lung Cancer's World Conference on Lung Cancer.
Dr. Jay M. Lee, chief, Division of Thoracic Surgery at Ronald Reagan UCLA Medical Center in Los Angeles, today reported on results from a study of 181 patients with stage IB to IIIB non-small cell lung ...
(Singapore--January 30, 2021 11:00 p.m. SPT/January 30, 2021 10:00 a.m. EST)-- A study presented today by researchers with the Ministry of Health and Welfare in Taiwan confirmed the effectiveness of low-dose computed tomography (LDCT) screening in a pre-defined, never-smoker, high-risk population. The research was presented today at the International Association for the Study of Lung Cancer 2021 World Conference on Lung Cancer.
In Taiwan, lung cancer is the leading cause of cancer mortality, and 53% of those have died of lung cancer were never-smokers. The National Lung Cancer Screening Trial (NLCST) and NELSON Trials demonstrated that the use of low-dose CT is effective for lung cancer screening; however, ...
(Singapore--4:45 p.m. SPT/3:45 a.m. EST January 30, 2021--Using a host immune classifier (HIC) test for patients with non-small cell lung cancer (NSCLC) may provide better predictors of treatment response and improve outcomes, according to research presented today at the International Association for the Study of Lung Cancer's 2020 World Conference on Lung Cancer Singapore.
Immune checkpoint inhibitors have revolutionized cancer care in patients with advanced stage aNSCLC, but better predictors of treatment response are still needed to guide treatment decisions for patients diagnosed with NSCLC, according to Dr. Wallace Akerley, of Huntsman Cancer Institute in Salt Lake City, Utah. HIC (Host Immune Classifier) is a serum proteomic measure of inflammation. ...
Nagoya University researchers and colleagues have revealed that colorectal cancer tissues contain at least two types of fibroblasts (a type of cells found in connective tissue), namely, cancer-promoting fibroblasts and cancer-restraining fibroblasts, and that the balance between them is largely involved in the progression of colorectal cancer. Their findings, recently published in the journal Gastroenterology, suggest that artificially altering the balance between the two types of cells could curb the spread of colorectal cancer tumors, which may become an effective strategy for preventing cancer progression.
Cancer tissues comprise both cancer cells and non-malignant cells such as fibroblasts. Previous studies have suggested that the proliferation of fibroblasts ...
(Singapore--January 29, 2021 9:35 a.m. SPT/January 28, 2021 8:35 p.m. EST)--Two radiation oncology trials presented at the IALSC World Conference on Lung Cancer Singapore highlight how some researchers are exploring use of higher radiation boost doses to only PET-positive regions in locally-advanced non-small cell lung cancer (NSCLC). A previous large RTOG phase III trial revealed that the unform delivery of a high dose to the entire tumor led to poorer survival.
In one study, Prof. Feng-Ming (Spring) Kong, Case Western Reserve University School of Medicine, in Cleveland, Ohio presented the results of a multicenter trial which aimed to ...
(Singapore Embargoed for 7:23pm EST on January 29, 2021 to coincide with publication in the Journal of Clinical Oncology) -- Adding ipilimumab to pembrolizumab does not improve efficacy and is associated with greater toxicity than pembrolizumab alone as first-line therapy for metastatic non-small cell lung cancer (NSCLC) for patients with a PD-L1 tumor proportion score of greater than or equal to 50% and no targetable EGFR or ALK aberrations, according to research presented today at the International Association for the Study of Lung Cancer's World Conference on Lung Cancer.
The research was presented ...
New research led by Carnegie Mellon University Assistant Professor of Physics Shiladitya Banerjee demonstrates how certain types of bacteria can adapt to long-term exposure to antibiotics by changing their shape. The work was published this month in the journal Nature Physics.
Adaptation is a fundamental biological process driving organisms to change their traits and behavior to better fit their environment, whether it be the famed diversity of finches observed by pioneering biologist Charles Darwin or the many varieties of bacteria that humans coexist with. While antibiotics have long helped people prevent and cure bacterial infections, many species of bacteria have increasingly been able to adapt to ...
School closures during COVID-19 have decreased access to school meals, which is likely to increase the risk for food insecurity among children in Maryland, according to a new report issued by researchers at the University of Maryland School of Medicine (UMSOM). The number of meals served to school-age children during the first three months of the pandemic dropped by 58 percent, compared to the number of free or reduced-price meals served the previous spring. As a result, thousands of children across the state were placed at increased risk of food insecurity, with many likely experiencing the health ramifications ...
