Changing patterns in Australian and New Zealand: vascular surgery during COVID-19.

ABSTRACT

BACKGROUND: Early government-mandated restrictions in Australia and New Zealand contributed to a successful public health outcome during the COVID-19 pandemic, including an unprecedented temporary cancellation of all non-urgent elective surgical procedures. This study describes the change in vascular surgery services across Australia and New Zealand before and during the COVID-19 restrictions. METHODS: De-identified data from the Australia and New Zealand Society for Vascular Surgery Australasian Vascular Audit from January 2015 to September 2020 was obtained. Vascular surgery procedure numbers from January to September of 2020 (study period) was compared to the corresponding months between 2015 and 2019 (pre-study period). The volume of procedures, both elective and emergency, were compared. Subgroup analyses included procedures categorized by operation type and location. RESULTS: There was a 11% decrease in total vascular procedures, 22% decrease in elective procedures, and a 14% increase in emergency procedures, comparing the study and pre-study periods. There was a large increase in all revascularization procedures for critical limb ischemia and no change in acute limb ischemia interventions, without a concomitant rise in major or minor all-cause amputation. There was a decrease in interventions for abdominal aortic aneurysm and carotid artery disease, driven by a fall in elective procedures, while volume for dialysis access remained the same. Change in procedural volume varied by state with the largest decrease noted in NSW and Victoria. CONCLUSIONS: The COVID-19 pandemic reduced vascular surgery procedures across Australia and New Zealand with a decrease in elective operations and an increase in emergency operations.