Dissecting the Management and Outcomes of Thoracic Aortovascular Disease During the COVID-19 Pandemic.
Ann Vasc Surg
; 75: 120-127, 2021 Aug.
Article
in English
| MEDLINE | ID: covidwho-1201420
ABSTRACT
OBJECTIVE:
The COVID-19 pandemic has forced the cancellation of planned surgery and led to significant surgical service reductions. Early intervention in aortovascular disease is often critical and cannot be deferred despite these reductions. There is urgent need to evaluate the provision and outcomes of thoracic aortovascular intervention during the peak of the pandemic.METHODS:
Prospective data was collected for patients receiving open and endovascular thoracic aortovascular intervention over two-time points; January-May 2020 and January-May 2019 at three tertiary cardiovascular centres. Baseline demographics, cardiovascular risk and COVID-19 screening results were noted. Primary outcomes were median length of intensive care unit and hospital stay, intra-operative mortality, 30-day mortality, post-operative stroke, and spinal cord injury.RESULTS:
Patients operated in 2020 (41) had significantly higher median EuroSCORE II than 2019 (53) (7.44 vs. 5.86, Pâ¯=â¯0.032) and rates of previous cardiac (19.5% vs. 3.8%, Pâ¯=â¯0.019), aortic (14.6% vs. 1.9%, Pâ¯=â¯0.041), and endovascular (22.0% vs. 3.8%, Pâ¯=â¯0.009) intervention. There was an increase in proportion of urgent cases in 2020 (31.7% vs. 18.9%). There were no intra-operative deaths in 2020 and 1 in 2019 (Pâ¯=â¯1.00). There were no significant differences (P ≥ 0.05) in 30-day mortality (4.9% vs. 13.2%), median intensive care unit length of stay (72 vs. 70 hr), median hospital length of stay (8 vs. 9 days), post-operative stroke (3 vs. 6), or spinal cord injury (2 vs. 1) between 2020 and 2019 respectively.CONCLUSIONS:
Despite the increased mortality risk of patients and urgency of cases during COVID-19, complicated by the introduction of cohorting and screening regimens, thoracic aortovascular intervention remained safe with comparable in outcomes to pre-COVID-19.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Aorta, Thoracic
/
Aortic Diseases
/
Vascular Surgical Procedures
/
COVID-19
Type of study:
Cohort study
/
Diagnostic study
/
Experimental Studies
/
Observational study
/
Prognostic study
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Europa
Language:
English
Journal:
Ann Vasc Surg
Journal subject:
Vascular Diseases
Year:
2021
Document Type:
Article
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