Use of Cardiac Procedures in People with Diabetes during the COVID Pandemic in Spain: Effects on the In-Hospital Mortality

Int J Environ Res Public Health. 2023 Jan 2;20(1):844. doi: 10.3390/ijerph20010844.

Abstract

We aimed to assess the effect of the COVID-19 pandemic in Spain on people with diabetes undergoing cardiac procedures, such as coronary artery bypass graft (CABG), percutaneous coronary intervention (PCI), open surgical valve replacement (OSVR), and transcatheter valve implantation (TCVI). We compared the year 2019 with the year 2020. We conducted an observational study using data from the Spanish National Hospital Discharge Database from 1 January 2019 to 31 December 2020. In 2020, a total of 21,067 cardiac procedures were performed on people with diabetes compared with 24,675 in the previous year. The use of CABG, PCI, OSVR and TCVI decreased from 2019 to 2020 by 13.9%, 14.8%, 21.4% and 2.9%, respectively. In 2020, patients had a significantly higher mean Charlson Comorbidity Index than in 2019 for all the cardiac procedures analyzed. In-hospital mortality (IHM) was higher (p > 0.05) for all the procedures in the year 2020. Over the entire period, female sex was a significant risk factor for IHM among those who underwent CABG, PCI and OSVR (OR 1.94, 95%CI 1.41-2.66; OR 1.19, 95%CI 1.05-1.35; and OR 1.79, 95%CI 1.38-2.32, respectively). The sensitivity analysis including two more years, 2017 and 2018, confirmed that female patients and comorbidity were risk factors for IHM in patients with diabetes regardless of whether it was during the pandemic era or before. We conclude that the frequency of cardiac procedures among people with diabetes declined in 2020. IHM did not change significantly in the COVID-19 era.

Keywords: COVID-19; cardiac procedures; diabetes; hospitalization; in-hospital mortality.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • COVID-19* / epidemiology
  • Coronary Artery Bypass
  • Diabetes Mellitus* / epidemiology
  • Female
  • Hospital Mortality
  • Humans
  • Pandemics
  • Percutaneous Coronary Intervention*
  • Retrospective Studies
  • Risk Factors
  • Spain / epidemiology
  • Treatment Outcome

Grants and funding

This study is a part of the research funded by the FIS (Fondo de Investigaciones Sanitarias—Health Research Fund, Instituto de Salud Carlos III) and co-financed by the European Union through the Fondo Europeo de Desarrollo Regional (FEDER, “Una manera de hacer Europa”): grant no. PI20/00118. And by: Convenio V-PRICIT de la Comunidad de Madrid y la Universidad Complutense de Madrid (“Programa de Excelencia para el Profesorado Universitario” INV.AY.20.2021.1E126). And by: Universidad Complutense de Madrid. Grupo de Investigación en Epidemiología de las Enfermedades Crónicas de Alta Prevalencia en España (970970).