Temporal Trends in Patients with Peripheral Artery Disease Influenced by COVID-19 Pandemic

Keller, Karsten; Schmitt, Volker H.; Hobohm, Lukas; Brochhausen, Christoph; Münzel, Thomas; Espinola‐Klein, Christine

doi:10.3390/jcm11216433

Cited by 6 publications

(2 citation statements)

References 49 publications

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“…This finding of increased revascularisations however, is not consistent with the existing, albeit scarce, literature on the topic where a decline in revascularisation for PAD has been observed during the pandemic [22][23][24]. However, many of these studies only evaluated the first wave of the pandemic therefore a potential increase in numbers due to delayed presentations and referrals cannot be excluded.…”

Section: Discussioncontrasting

confidence: 83%

The indirect impact of COVID‐19 pandemic on limb preservation care– a retrospective analysis of trends in lower limb revascularisation

Anthony

Gillies

Tran

et al. 2023

Journal of Foot and Ankle Research

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Background Disruptions caused by COVID-19 pandemic have profoundly influenced the management of many conditions, especially vascular pathologies including limb preservation care. The aim of this study is to evaluate the impact of the pandemic on patients with peripheral arterial disease (PAD) focusing on lower limb revascularisation procedure volume, their indication and urgency of surgery. Methods The Australian Vascular Audit (AVA) was used to capture data on revascularisation procedures before and after the onset of the pandemic in Victoria, Australia. Information on patient demographics, procedures performed, their indication and urgency of surgery were collected. Results There was a significant 22.7% increase in revascularisations for PAD during the COVID-19 pandemic, driven solely by a 31.9% increase in endovascular revascularisation procedures. Revascularisation procedures for all indications of PAD, namely claudication, rest pain and tissue loss, increased by 14.8%, 39.2% and 27.4% respectively, during the pandemic compared to pre-pandemic times. Open procedures declined by 10.2% during the pandemic. There were significant 13.9% and 62.2% increases in elective and semi-urgent revascularisations respectively during the pandemic while emergency revascularisations for PAD fell by 4.2%. There were no significant increases in toe, forefoot or below knee amputations during the pandemic compared to pre-pandemic times. Conclusions This study found that the volume of revascularisation for PAD increased significantly during the pandemic indicating that patients with PAD had significant deterioration of their condition during the pandemic. This is likely multifactorial; due to disruptions to standard provision of podiatry, vascular surgery and endocrinology services to these patients, a decline in overall health and changes in health-related behaviours due to restrictions and infection control methods imposed during the pandemic. The number of elective and semi-urgent procedures also increased during the pandemic which reflects the significant deterioration of PAD patients during the pandemic. This study highlights a concerning trend of worsening PAD when routine care of these patients is disrupted. Such data should be instrumental in contingency planning and resource allocation for managing the ongoing pandemic.

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Section: Discussioncontrasting

confidence: 83%

The indirect impact of COVID‐19 pandemic on limb preservation care– a retrospective analysis of trends in lower limb revascularisation

Anthony

Gillies

Tran

et al. 2023

Journal of Foot and Ankle Research

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“…Others have reported that admissions for MI were significantly reduced during the COVID-19 pandemic, with a parallel increase in fatality and complication rates [10][11][12]. Numbers of hospital admissions of PAD patients were also reduced [13].…”

Section: Introductionmentioning

confidence: 95%

Impact of COVID 19 on Hospitalization for Thromboembolic Diseases in Germany

2023

Curr Trends Intern Med

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Objectives: We compared hospitalization rates for thrombotic venous and arterial disease in 2020 and 2021 of the COVID-19 pandemic with the 3-year period from 2017 to 2019 before. Patients and Methods: Lists of hospitalizations with principal diagnoses of Pulmonary Embolism (PE), Deep Vein (DVT), Sinus Vein (SVT) and Portal Vein Thrombosis (PVT), Budd-Chiari-Syndrome (BCS), Myocardial Infarction (MI), Embolic Stroke (ES), and acute Peripheral Embolism and Thrombosis (PET) were provided by the Federal Statistical Office in Germany. Results:The number of hospitalizations was fairly constant before the COVID-19 pandemic for PE, PVT, BCS, MI, and ES; those for DVT and PET were trending downward; and those for SVT were trending upward. In 2020, absolute number of all hospitalizations was 13.8% lower than the average from 2017 to 2019. Contrary to this trend, hospitalized cases for SVT, BCS, and ES were within the 95%-CI of the 3 years before COVID-19, and they were lower for PE, DVT, PVT, MI, and PET. In 2021, absolute number of all hospitalizations was 14.6% lower. Contrary to this trend, the absolute number of hospitalizations for PE, SVT, and ES was above the upper limit of the 95%-CI of the 3 years before COVID-19.The increase in PE in 2021 occurred in the 50-to 80-year age groups, and the decrease in MI and PET in the 70-and 85-year age groups. The increase in SVT affected all age groups. Conclusion:The analysis shows that the COVID-19 pandemic does not affect all venous and arterial diseases equally.

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Drivers and recent trends of hospitalisation costs related to acute pulmonary embolism

Mohr,

Hobohm,

Kaier

et al. 2024

Clin Res Cardiol

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Background and aims The socio-economic burden imposed by acute pulmonary embolism (PE) on European healthcare systems is largely unknown. We sought to determine temporal trends and identify cost drivers of hospitalisation for PE in Germany. Methods and results We analysed the totality of reimbursed hospitalisation costs in Germany (G-DRG system) in the years 2016–2020. Overall, 484 884 PE hospitalisations were coded in this period. Direct hospital costs amounted to a median of 3572 (IQR, 2804 to 5869) euros, resulting in average total reimbursements of 710 million euros annually. Age, PE severity, comorbidities and in-hospital (particularly bleeding) complications were identified by multivariable logistic regression as significant cost drivers. Use of catheter-directed therapy (CDT) constantly increased (annual change in the absolute proportion of hospitalisations with CDT + 0.40% [95% CI + 0.32% to + 0.47%]; P < 0.001), and it more than doubled in the group of patients with severe PE (28% of the entire population) over time. Although CDT use was overall associated with increased hospitalisation costs, this association was no longer present (adjusted OR 1.02 [0.80–1.31]) in patients with severe PE and shock; this was related, at least in part, to a reduction in the median length of hospital stay (for 14.0 to 8.0 days). Conclusions We identified current and emerging cost drivers of hospitalisation for PE, focusing on severe disease and intermediate/high risk of an adverse early outcome. The present study may inform reimbursement decisions by policymakers and help to guide future health economic analysis of advanced treatment options for patients with PE. Graphical Abstract

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Temporal Trends in Patients with Peripheral Artery Disease Influenced by COVID-19 Pandemic

Cited by 6 publications

References 49 publications

The indirect impact of COVID‐19 pandemic on limb preservation care– a retrospective analysis of trends in lower limb revascularisation

The indirect impact of COVID‐19 pandemic on limb preservation care– a retrospective analysis of trends in lower limb revascularisation

Impact of COVID 19 on Hospitalization for Thromboembolic Diseases in Germany

Drivers and recent trends of hospitalisation costs related to acute pulmonary embolism

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