The Vascular Surgery COVID-19 Collaborative (VASCC)

Mouawad, Nicolas J.; Cuff, Robert; Hultgren, Rebecka; Chuen, Jason; Galeazzi, Edoardo; Wohlauer, Max V.

doi:10.1016/j.jvs.2020.04.463

Cited by 38 publications

(25 citation statements)

References 4 publications

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“…The unknown sequelae of unanticipated delays on vascular surgical care and patient outcomes prompted the creation of the Vascular Surgery COVID-19 Collaborative (VASCC) to prospectively follow these impacts. 18 …”

Section: Discussionmentioning

confidence: 99%

The impact of the COVID-19 pandemic on vascular surgery practice in the United States

Mouawad

Woo

Malgor

et al. 2021

Journal of Vascular Surgery

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Introduction The coronavirus disease 2019 (COVID-19) pandemic has led to widespread postponement and cancelation of elective surgeries in the United States. We designed and administered a global survey to examine the impact of COVID-19 on vascular surgeons. We describe the impact of the pandemic on the practices of Vascular Surgeons in the United States. Methods The Pandemic Practice, Anxiety, Coping, and Support Survey for Vascular Surgeons is an anonymous cross-sectional survey sponsored by the Society for Vascular Surgery Wellness Task Force disseminated April 14-24, 2020. This analysis focuses on pattern changes in vascular surgery practices in the United States including the inpatient setting, ambulatory, and vascular laboratory setting. Specific questions regarding occupational exposure to COVID-19, adequacy of personal protective equipment (PPE), elective surgical practice, changes in call schedule, and redeployment to non-vascular surgery duties were also included in the survey. Regional variation was assessed. The survey data were collected using REDCap and analyzed using descriptive statistics. Results A total of 535 vascular surgeons responded to the survey from 45 states. Most of the respondents were male (73.1%), White (70.7%), practiced in urban settings (81.7%), and in teaching hospitals (66.8%). Almost half were in hospitals with greater than 400 beds (46.4%). There was no regional variation in the presence of pre-operative COVID-19 testing, COVID-19 OR protocols, adherence to national surgical standards, and the presence of PPE. The overwhelming majority of respondents (91.7%) noted elective surgery cancellation, with the Northeast and Southeast regions having the most case cancellations 94.2% and 95.8% respectively %). The Northeast region reported the highest percentage of operations/procedures on patients with COVID-19, which was either identified at the time of the surgery or later in the hospital course (82.7%). Ambulatory visits were performed via telehealth (81.3%), with 71.1% having restricted hours. Over half of OBLs were closed, although there was regional variation with over 80% in the Midwest being closed. Cases performed in OBLs focused on critical limb ischemia (42.9%) and dialysis access maintenance (39.9%). Call schedules modifications were common, although the number of call days remained the same (45.8%). Conclusions Vascular surgeons in the United States report substantial impact on their practices during the COVID-19 pandemic, and regional variations are demonstrated - particularly in OBL utilization, ICU bed availability, and COVID-19 exposure at work.

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Section: Discussionmentioning

confidence: 99%

The impact of the COVID-19 pandemic on vascular surgery practice in the United States

Mouawad

Woo

Malgor

et al. 2021

Journal of Vascular Surgery

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“…The VLFDC is a multi-institutional collaboration, initiated 20 years ago, designed to investigate uncommon vascular diseases. 14 The VASCC was established on March 2, 2020, to study the impact of the ongoing COVID-19 pandemic on vascular surgical care, 15 using an international registry.…”

Section: Methodsmentioning

confidence: 99%

Managing central venous access during a health care crisis

Chun

Judelson

Rigberg

et al. 2020

Journal of Vascular Surgery

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Objective: During the COVID-19 pandemic, central venous access line teams were implemented at many hospitals throughout the world to provide access for critically ill patients. The objective of this study was to describe the structure, practice patterns, and outcomes of these vascular access teams during the COVID-19 pandemic. Methods: We conducted a cross-sectional, self-reported study of central venous access line teams in hospitals afflicted with the COVID-19 pandemic. To participate in the study, hospitals were required to meet one of the following criteria: development of a formal plan for a central venous access line team during the pandemic; implementation of a central venous access line team during the pandemic; placement of central venous access by a designated practice group during the pandemic as part of routine clinical practice; or management of an iatrogenic complication related to central venous access in a patient with COVID-19. Results: Participants from 60 hospitals in 13 countries contributed data to the study. Central venous line teams were most commonly composed of vascular surgery and general surgery attending physicians and trainees. Twenty sites had 2657 lines placed by their central venous access line team or designated practice group. During that time, there were 11 (0.4%) iatrogenic complications associated with central venous access procedures performed by the line team or group at those 20 sites. Triple lumen catheters, Cordis (Santa Clara, Calif) catheters, and nontunneled hemodialysis catheters were the most common types of central venous lines placed by the teams. Eight (14%) sites reported experience in placing central venous lines in prone, ventilated patients with COVID-19. A dedicated line cart was used by 35 (59%) of the hospitals. Less than 50% (24 [41%]) of the participating sites reported managing thrombosed central lines in COVID-19 patients. Twentythree of the sites managed 48 iatrogenic complications in patients with COVID-19 (including complications caused by providers outside of the line team or designated practice group). Conclusions: Implementation of a dedicated central venous access line team during a pandemic or other health care crisis is a way by which physicians trained in central venous access can contribute their expertise to a stressed health care system. A line team composed of physicians with vascular skill sets provides relief to resource-constrained intensive care unit, ward, and emergency medicine teams with a low rate of iatrogenic complications relative to historical reports. We recommend that a plan for central venous access line team implementation be in place for future health care crises.

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“…VASCC was established to provide vascular surgeons from around the world with the opportunity to study the fundamental issues facing our specialty through two distinct research projects. 5 Project 1: "Impact of COVID-19 on scheduled vascular operations". This project provides a mechanism to formally assess the impact of surgical delay on patients with vascular disease and will investigate the natural history of those whose operations were postponed as a result of the pandemic.…”

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confidence: 99%

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confidence: 99%