Impact of COVID-19 Pandemic on the Outcomes in Patients With Critical Limb Threatening Ischaemia and Diabetic Foot Infection.
Ann Surg
; 275(6): 1037-1042, 2022 06 01.
Article
in English
| MEDLINE | ID: covidwho-1101933
ABSTRACT
OBJECTIVE:
Examine the impact of COVID-19 pandemic on the outcomes in patients with CLTI or DFI.BACKGROUND:
Patients with CLTI and/or DFI are at risk of amputations if not treated in a timely manner.METHODS:
We compared the outcomes in patients with CLTI or DFI during 2 periods; Period 1[P1] (15/03/2019-31/05/2019) and period 2[P2] (15/03/ 2020-31/05/2020- corresponding to COVID-19 pandemic).RESULTS:
One hundred thirty-nine patients were treated in P1 [mean age 70âyears (±11), MaleFemale = 10237] whereas 95 patients were treated in P2 [mean age 67 (±12), MaleFemale = 6431]. The 2 cohorts were matched regarding Rutherford category (P = 0.25) and GLASS classification (P = 0.38). Notably, the time from onset of symptom to clinical presentation was significantly longer [31 (1-105) days vs 27 (0-78) days, (P = 0.017)], whereas the time from presentation to first intervention was significantly shorter [3 (0-61) days vs 5 (0-65) days, (P = 0.013)] in P2 compared to P1. There was a significantly higher white cell count (P = 0.014) and CRP (P = 0.004) on admission in P2. Having treatment for CLTI or DFI in P2 was an independent predictor of worse primary patency rate and freedom from major adverse limb events. At 90âdays, amputation-free survival and limb salvage were noticeably worse in P2 compared to P1 (amputation-free survival was 80% and 87% whereas limb salvage was 64% and 72% in P2 and P1, respectively).CONCLUSIONS:
Patients with CLTI and DFI experienced a significantly delayed presentation with features of sepsis on admission in P2. Treatment in P2 was a predictor of worse primary patency and freedom from major adverse limb events and therefore close and long follow-up is advisable.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Diabetic Foot
/
Diabetes Mellitus
/
Peripheral Arterial Disease
/
Endovascular Procedures
/
COVID-19
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
Topics:
Long Covid
Limits:
Aged
/
Female
/
Humans
/
Male
Language:
English
Journal:
Ann Surg
Year:
2022
Document Type:
Article
Affiliation country:
SLA.0000000000004677
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