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2.
J Vasc Surg ; 73(6): 1852-1857, 2021 06.
Article in English | MEDLINE | ID: covidwho-1198952

ABSTRACT

In the present report, we have described the abrupt pivot of Vascular Quality Initiative physician members away from standard clinical practice to a restrictive phase of emergent and urgent vascular procedures in response to the coronavirus disease 2019 (COVID-19) pandemic. The Society for Vascular Surgery Patient Safety Organization queried both data managers and physicians in May 2020 to discern the effects of the COVID-19 pandemic. Approximately three fourths of physicians (74%) had adopted a restrictive operating policy for urgent and emergent cases only. However, one half had considered "time sensitive" elective cases as urgent. Data manager case entry was affected by both low case volumes and low staffing resulting from reassignment or furlough. A sevenfold reduction in arterial Vascular Quality Initiative case volume entry was noted in the first quarter of 2020 compared with the same period in 2019. The downstream consequences of delaying vascular procedures for carotid artery stenosis, aortic aneurysm repair, vascular access, and chronic limb ischemia remain undetermined. Further ramifications of the COVID-19 pandemic shutdown will likely be amplified if resumption of elective vascular care is delayed beyond a short window of time.


Subject(s)
Arteries/surgery , COVID-19 , Registries , Societies, Medical , Vascular Surgical Procedures/standards , Health Care Surveys , Humans , Quality of Health Care , United States
3.
J Vasc Surg Venous Lymphat Disord ; 9(5): 1093-1098, 2021 09.
Article in English | MEDLINE | ID: covidwho-1039471

ABSTRACT

In response to the pandemic, an abrupt pivot of Vascular Quality Initiative physician members away from standard clinical practice to a restrictive phase of emergent and urgent vascular procedures occurred. The Society for Vascular Surgery Patient Safety Organization queried both data managers and physicians in May 2020. Approximately three-fourths (74%) of physicians adopted restrictive operating policies for urgent and emergent cases only, whereas one-half proceeded with "time sensitive" elective cases as urgent. Data manager case entry was negatively affected by both low case volumes and staffing due to reassignment or furlough. Venous registry volumes were reduced fivefold in the first quarter of 2020 compared with a similar period in 2019. The consequences of delaying vascular procedures for ambulatory venous practice remain unknown with increased morbidity likely. Challenges to determine venous thromboembolism mortality impact exist given difficulty in verifying "in home and extended care facility" deaths. Further ramifications of a pandemic shutdown will likely be amplified if postponement of elective vascular care extends beyond a short window of time. It will be important to monitor disease progression and case severity as a result of policy shifts adopted locally in response to pandemic surges.


Subject(s)
COVID-19 , Practice Patterns, Physicians'/trends , Prosthesis Implantation/trends , Surgeons/trends , Varicose Veins/therapy , Vascular Surgical Procedures/trends , Vena Cava Filters/trends , Venous Thromboembolism/therapy , Elective Surgical Procedures/trends , Health Care Surveys , Humans , Prosthesis Implantation/adverse effects , Prosthesis Implantation/instrumentation , Registries , Time Factors , Treatment Outcome , Varicose Veins/diagnostic imaging , Vascular Surgical Procedures/adverse effects , Venous Thromboembolism/diagnostic imaging , Workload
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