Infectious Disease

CABG, surgical AVR might be secure regardless of the severity of the flu season and period

December 31, 2020

2 min read

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Mori does not report any relevant financial information. In the study you will find all relevant financial information from all other authors.

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According to a study published on JAMA Network Open, CABG or AVR surgical procedures can be safely performed even during the worst influenza seasons.

“In older adults who underwent elective coronary and aortic valve surgery during the influenza season, there were no consistent associations between the severity of the influenza season and the risk of mortality or readmission,” said Dr. Makoto Mori, a surgeon at the Center for Outcomes Research and Evaluation at Yale-New Haven Hospital, and colleagues wrote. “With CABG procedures, increasing seasonal severity may be associated with a slightly higher risk of 30-day mortality.”

Woman with flu

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Using the Medicare inpatient fee data, the researchers identified 313,159 people who had CABG (mean age 73 years; 71% men) and 135,550 people who had surgical AVR (mean age 76 years; 61% men) during the influenza season ) received (November 1 to March 31) between 2003 and 2017.

“Patients recovering from major surgery are increasingly prone to respiratory complications. However, whether surgery during heavier influenza seasons is associated with a higher risk of respiratory complications is unknown,” the researchers write.

The duration and severity of the influenza seasons were defined as mild, moderate, and severe according to CDC statistics, based on the frequency of influenza-associated hospitalizations and deaths related to pneumonia or influenza.

Of the influenza seasons studied, six were mild, five were moderate, and four were severe.

“Because elective procedures can be postponed to reduce the potential risk, we assessed the associations between the severity of the influenza seasons and the risk of mortality and readmission to hospital after elective coronary artery bypass grafting (CABG) and aortic valve replacement surgery,” write the explorers.

Findings of interest included in-hospital and 30-day mortality and 30-day readmission for all causes and pneumonia.

The researchers observed that patients in whom during moderate (OR = 1.06; 95% CI, 1.01-1.11) and severe (OR = 1.06; 95% CI, 1.01-1.12 ) Influenza seasons a CABG was performed compared to patients who had a higher risk of 30-day mortality who were operated on during milder seasons (P = 0.03).

In patients with surgical AVR, the 30-day mortality risk was moderate (OR = 1.03; 95% CI, 0.96-1.1) or severe (OR = 1.01; 95% CI, 0.94- 1.06) Influenza seasons compared to milder seasons not significantly higher (P = 0.66).

In addition, the risk of all-cause readmission for CABG or surgical AVR performed during a moderate phase was not significantly higher (OR for CABG = 0.99; 95% CI, 0.97-1.01; OR for surgical AVR = 0.99; 95% CI, 0.96-1.02) or severe influenza seasons (OR for CABG = 0.92; 95% CI, 0.9-0.95; OR for surgical AVR = 0.93; 95% CI, 0.9-0.96) compared to mild influenza seasons.

“Our large sample suggests that it is safe to perform elective major surgery regardless of the severity of the influenza seasons,” the researchers wrote.

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