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Wyler von Ballmoos MC, Kaneko T, Iribarne A, Kim KM, Arghami A, Fiedler A, Habib R, Parsons N, Elhalabi Z, Krohn C, Bowdish ME. The Society of Thoracic Surgeons Adult Cardiac Surgery Database: 2023 Update on Procedure Data and Research. Ann Thorac Surg 2024; 117:260-270. [PMID: 38040323 DOI: 10.1016/j.athoracsur.2023.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 11/09/2023] [Accepted: 11/18/2023] [Indexed: 12/03/2023]
Abstract
The Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database is one of the largest and most comprehensive contemporary clinical databases in use. It now contains >9 million procedures from 1010 participants and 3651 active surgeons. Using audited data collection, it has provided the foundation for multiple risk models, performance metrics, health policy decisions, and a trove of research studies to improve the care of patients in need of cardiac surgical procedures. This annual report provides an update on the current status of the database and summarizes the development of new risk models and the STS Online Risk Calculator. Further, it provides insights into current practice patterns, such as the change in the demographics among patients undergoing aortic valve replacement, the use of minimally invasive techniques for valve and bypass surgery, or the adoption of surgical ablation and left atrial appendage ligation among patients with atrial fibrillation. Lastly, an overview of the research conducted using the STS Adult Cardiac Surgery Database and future directions for the database are provided.
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Affiliation(s)
- Moritz C Wyler von Ballmoos
- Department of Cardiovascular Surgery, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
| | - Tsuyoshi Kaneko
- Division of Cardiothoracic Surgery, Washington University in St. Louis, St. Louis, Missouri
| | - Alexander Iribarne
- Department of Cardiothoracic Surgery, Staten Island University Hospital, Staten Island, New York
| | - Karen M Kim
- Institute for Cardiovascular Health, UT Health Austin, Austin, Texas
| | - Arman Arghami
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota
| | - Amy Fiedler
- Division of Cardiothoracic Surgery, Department of Surgery, University of California, San Francisco, San Francisco, California
| | - Robert Habib
- The Society of Thoracic Surgeons, Chicago, Illinois
| | | | | | - Carole Krohn
- The Society of Thoracic Surgeons, Chicago, Illinois
| | - Michael E Bowdish
- Department of Cardiac Surgery, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
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Brennan Z, Bowdish ME. Understanding Aortic Disease: Why We Really Need Big Data. Ann Thorac Surg 2023; 116:1185. [PMID: 37573996 DOI: 10.1016/j.athoracsur.2023.07.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 07/29/2023] [Indexed: 08/15/2023]
Affiliation(s)
- Zachary Brennan
- Department of Cardiac Surgery, Smidt Heart Institute, Cedars Sinai Medical Center, 127 S San Vicente Blvd, AHSP-Ste A3600, Los Angeles, CA 90048
| | - Michael E Bowdish
- Department of Cardiac Surgery, Smidt Heart Institute, Cedars Sinai Medical Center, 127 S San Vicente Blvd, AHSP-Ste A3600, Los Angeles, CA 90048.
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Bima P, Giamello JD, Rubiolo P, Risi F, Balzaretti P, Lauria G, Vallino D, Lupia E, Morello F. Clinical Presentation and Emergency Department Management Checkpoints of Acute Aortic Syndromes during the First Two Waves of the COVID-19 Pandemic. J Clin Med 2023; 12:6601. [PMID: 37892739 PMCID: PMC10607079 DOI: 10.3390/jcm12206601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/13/2023] [Accepted: 10/14/2023] [Indexed: 10/29/2023] Open
Abstract
The COVID-19 pandemic has deeply affected the activity and patient flows of Emergency Departments (EDs), and concern for the worsening outcome of cardiovascular emergencies has been raised. However, the impact of COVID-19 on all subtypes of acute aortic syndromes (AASs) has not been evaluated so far. Cases of AASs managed in the ED of three hub hospitals in a large area of Northern Italy were retrospectively analyzed, comparing those registered during the pandemic (March 2020 to May 2021) with corresponding pre-COVID-19 periods. A total of 124 patients with AAS were managed during the COVID-19 period vs. 118 pre-COVID-19 (p = 0.70), despite a -34.6% change in ED visits. Posterior chest pain at presentation was the only clinical variable with a different prevalence (46.0% vs. 32.2%, p = 0.03). Surgery and endovascular treatment rates were unchanged. Time intervals influenced by patient transfer to the hub center were longer during the COVID-19 period and longest during high viral circulation periods. Ninety-day mortality was unchanged, with a higher mortality trend during the pandemic surges. In conclusion, ED presentation and care of AASs were marginally affected by COVID-19, but efforts are needed to preserve efficient patient transfer to specialized centers and prevent mortality, especially during pandemic peaks.
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Affiliation(s)
- Paolo Bima
- S.C. Medicina d’Urgenza U (MECAU), Ospedale Molinette, A.O.U. Città della Salute e della Scienza, 10126 Torino, Italy; (P.B.); (E.L.)
- Dipartimento di Scienze Mediche, Università degli Studi di Torino, 10126 Torino, Italy; (J.D.G.)
- Cardiovascular Research Institute Basel (CRIB), 4056 Basel, Switzerland
| | - Jacopo Davide Giamello
- Dipartimento di Scienze Mediche, Università degli Studi di Torino, 10126 Torino, Italy; (J.D.G.)
- Medicina d’Urgenza, Ospedale S. Croce e Carle, 12100 Cuneo, Italy
| | - Paolo Rubiolo
- Dipartimento di Scienze Mediche, Università degli Studi di Torino, 10126 Torino, Italy; (J.D.G.)
| | - Francesca Risi
- Dipartimento di Emergenza e Accettazione, Ospedale Mauriziano, 10128 Torino, Italy
| | - Paolo Balzaretti
- Dipartimento di Emergenza e Accettazione, Ospedale Mauriziano, 10128 Torino, Italy
| | - Giuseppe Lauria
- Medicina d’Urgenza, Ospedale S. Croce e Carle, 12100 Cuneo, Italy
| | - Domenico Vallino
- Dipartimento di Emergenza e Accettazione, Ospedale Mauriziano, 10128 Torino, Italy
| | - Enrico Lupia
- S.C. Medicina d’Urgenza U (MECAU), Ospedale Molinette, A.O.U. Città della Salute e della Scienza, 10126 Torino, Italy; (P.B.); (E.L.)
- Dipartimento di Scienze Mediche, Università degli Studi di Torino, 10126 Torino, Italy; (J.D.G.)
| | - Fulvio Morello
- S.C. Medicina d’Urgenza U (MECAU), Ospedale Molinette, A.O.U. Città della Salute e della Scienza, 10126 Torino, Italy; (P.B.); (E.L.)
- Dipartimento di Scienze Mediche, Università degli Studi di Torino, 10126 Torino, Italy; (J.D.G.)
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Zhang H, Yin L, Zhang Y, Qiu Z, Peng S, Wang Z, Sun B, Ding J, Liu J, Du K, Wang M, Sun Y, Chen J, Zhao H, Song T, Sun Y. Short-term effects of air pollution and weather changes on the occurrence of acute aortic dissection in a cold region. Front Public Health 2023; 11:1172532. [PMID: 37601173 PMCID: PMC10433911 DOI: 10.3389/fpubh.2023.1172532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 07/13/2023] [Indexed: 08/22/2023] Open
Abstract
Background Air pollution and severe weather conditions can adversely affect cardiovascular disease emergencies. Nevertheless, it remains unclear whether air pollutants and low ambient temperature can trigger the occurrence of acute aortic dissection (AAD) in cold regions. Methods We applied a retrospective analysis to assess the short-term effects of air pollution and ambient temperature on the occurrence of AAD in Harbin, China. A total of 564 AAD patients were enrolled from a major hospital in Harbin between January 1, 2017, and February 5, 2021. Weather condition data and air pollutant concentrations, including fine particulate matter smaller than 10 μm (PM10) and 2.5 μm in diameter (PM2.5), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO), and ozone (O3), were collected every day. Conditional logistic regressions and correlation analysis were applied to analyze the relationship of environmental and atmospheric parameters with AAD occurrence at lags of 0 to 7 days. Specifically, we appraised the air quality index, CO, NO2, SO2, O3, PM10, PM2.5, temperature, dew point temperature, atmospheric pressure, and cloud amount. Results A total of 1,496 days at risk were assessed, of which 564 patients developed AAD. Specifically, AAD did not occur on 1,043 (69.72%) days, while 1 or more cases occurred on 453 (30.28%) days. Several pollution and weather predictors for AAD were confirmed by multilevel modeling. The air quality index (p = 0.0012), cloud amount (p = 0.0001), and concentrations of PM2.5 (p = 0.0004), PM10 (p = 0.0013), NO2 (p = 0.0007) and O3 (p = 0.0001) predicted AAD as early as 7 days before the incident (lag of 7 days) in the study period. However, only concentrations of the air pollutants NO2 (p = 0.0468) and O3 (p = 0.011) predicted the occurrence of AAD after the COVID-19 outbreak. Similar predictive effects were observed for temperature, dew point temperature, and atmospheric pressure (all p < 0.05) on all days. Conclusion The risk of AAD is closely related to air pollution and weather characteristics in Harbin. While causation was not determined, the impact of air pollutants on the risk of AAD was reduced after the COVID-19 outbreak.
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Affiliation(s)
- Haiyu Zhang
- Department of Cardiology, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Leilei Yin
- Department of Emergency, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yingtao Zhang
- School of Computer Science and Technology, Harbin Institute of Technology, Harbin, China
| | - Zhaowen Qiu
- School of Information and Computer Engineering, Northeast Forestry University, Harbin, Heilongjiang, China
| | - Sizheng Peng
- Department of Cardiology, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Zhonghua Wang
- Department of Cardiology, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Bo Sun
- Department of Cardiology, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Jianrui Ding
- School of Computer Science and Technology, Harbin Institute of Technology, Weihai, Shandong, China
| | - Jing Liu
- Department of Cardiology, Harbin Second Hospital, Harbin, China
| | - Kai Du
- Department of Cardiology, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Mingxin Wang
- Department of Cardiology, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Yanming Sun
- Department of Cardiology, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Jing Chen
- Department of Cardiology, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Hongyan Zhao
- Department of Medical Record, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Tao Song
- Department of Cardiology, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Yuhui Sun
- Department of Obstetrics and Gynecology, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
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