Outcomes of Vascular and Endovascular Interventions Performed During the Coronavirus Disease 2019 (COVID-19) Pandemic.
Ann Surg
; 273(4): 630-635, 2021 04 01.
Article
in English
| MEDLINE | ID: covidwho-1304013
ABSTRACT
OBJECTIVE:
The aim of the COVER Study is to identify global outcomes and decision making for vascular procedures during the pandemic. BACKGROUND DATA During its initial peak, there were many reports of delays to vital surgery and the release of several guidelines advising later thresholds for vascular surgical intervention for key conditions.METHODS:
An international multi-center observational study of outcomes after open and endovascular interventions.RESULTS:
In an analysis of 1103 vascular intervention (57 centers in 19 countries), 71.6% were elective or scheduled procedures. Mean age was 67â±â14 years (75.6% male). Suspected or confirmed COVID-19 infection was documented in 4.0%. Overall, in-hospital mortality was 11.0% [aortic interventions mortality 15.2% (23/151), amputations 12.1% (28/232), carotid interventions 10.7% (11/103), lower limb revascularisations 9.8% (51/521)]. Chronic obstructive pulmonary disease [odds ratio (OR) 2.02, 95% confidence interval (CI) 1.30-3.15] and active lower respiratory tract infection due to any cause (OR 24.94, 95% CI 12.57-241.70) ware associated with mortality, whereas elective or scheduled cases were lower risk (OR 0.4, 95% CI 0.22-0.73 and 0.60, 95% CI 0.45-0.98, respectively. After adjustment, antiplatelet (OR 0.503, 95% CI 0.273-0.928) and oral anticoagulation (OR 0.411, 95% CI 0.205-0.824) were linked to reduced risk of in-hospital mortality.CONCLUSIONS:
Mortality after vascular interventions during this period was unexpectedly high. Suspected or confirmed COVID-19 cases were uncommon. Therefore an alternative cause, for example, recommendations for delayed surgery, should be considered. The vascular community must anticipate longer term implications for survival.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Vascular Surgical Procedures
/
Cardiovascular Diseases
/
COVID-19
Type of study:
Cohort study
/
Diagnostic study
/
Experimental Studies
/
Observational study
/
Prognostic study
Topics:
Long Covid
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
English
Journal:
Ann Surg
Year:
2021
Document Type:
Article
Affiliation country:
Sla.0000000000004722
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