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J Vasc Surg ; 73(6): 1876-1880.e1, 2021 06.
Article in English | MEDLINE | ID: covidwho-1065425


OBJECTIVE: The delays in elective surgery caused by the coronavirus disease 2019 (COVID-19) pandemic have resulted in a substantial backlog of cases. In the present study, we sought to determine the estimated time to recovery for vascular surgery procedures delayed by the COVID-19 pandemic in a regional health system. METHODS: Using data from a 35-hospital regional vascular surgical collaborative consisting of all hospitals performing vascular surgery in the state of Michigan, we estimated the number of delayed surgical cases for adults undergoing carotid endarterectomy, carotid stenting, endovascular and open abdominal aortic aneurysm repair, and lower extremity bypass. We used seasonal autoregressive integrated moving average models to predict the surgical volume in the absence of the COVID-19 pandemic and historical data to predict the elective surgical recovery time. RESULTS: The median statewide monthly vascular surgical volume for the study period was 439 procedures, with a maximum statewide monthly case volume of 519 procedures. For the month of April 2020, the elective vascular surgery procedural volume decreased by ∼90%. Significant variability was seen in the estimated hospital capacity and estimated number of backlogged cases, with the recovery of elective cases estimated to require ∼8 months. If hospitals across the collaborative were to share the burden of backlogged cases, the recovery could be shortened to ∼3 months. CONCLUSIONS: In the present study of vascular surgical volume in a regional health collaborative, elective surgical procedures decreased by 90%, resulting in a backlog of >700 cases. The recovery time if all hospitals in the collaborative were to share the burden of backlogged cases would be reduced from 8 months to 3 months, underscoring the necessity of regional and statewide policies to minimize patient harm by delays in recovery for elective surgery.

COVID-19 , Elective Surgical Procedures/statistics & numerical data , Models, Statistical , Time-to-Treatment/statistics & numerical data , Vascular Surgical Procedures/statistics & numerical data , Humans , Retrospective Studies
Vascular ; 29(6): 856-864, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1052392


BACKGROUND/OBJECTIVE: The unprecedented pandemic spread of the novel coronavirus has severely impacted the delivery of healthcare services in the United States and around the world, and has exposed a variety of inefficiencies in healthcare infrastructure. Some states have been disproportionately affected such as New York and Michigan. In fact, Detroit and its surrounding areas have been named as the initial Midwest epicenter where over 106,000 cases have been confirmed in April 2020. METHOD, RESULTS AND CONCLUSIONS: Facilities in Southeast Michigan have served as the frontline of the pandemic in the Midwest and in order to cope with the surge, rapid, and in some cases, complete restructuring of care was mandatory to effect change and attempt to deal with the emerging crisis. We describe the initial experience and response of 4 large vascular surgery health systems in Michigan to COVID-19.

COVID-19 , Health Care Rationing , Hospital Restructuring , Infection Control , Resource Allocation , Vascular Diseases , Vascular Surgical Procedures , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/therapy , Civil Defense/standards , Hospital Restructuring/methods , Hospital Restructuring/organization & administration , Humans , Infection Control/methods , Infection Control/organization & administration , Michigan/epidemiology , Organizational Innovation , Patient Selection , SARS-CoV-2 , Telemedicine/organization & administration , Vascular Diseases/diagnosis , Vascular Diseases/epidemiology , Vascular Diseases/surgery , Vascular Surgical Procedures/organization & administration , Vascular Surgical Procedures/statistics & numerical data