Treating Peripheral Arterial Occlusive Disease and Acute Limb Ischemia During a COVID-19 Pandemic in 2020

Exelmans, W; Knaapen, L.; Winter, Ljm Boonman-de; Vriens, P H W E; Laan, Lijckle van der

doi:10.1016/j.avsg.2022.01.012

Cited by 3 publications

(1 citation statement)

References 14 publications

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“…Equally impressive was the relative increase in the proportion of patients with acute limb ischemia, i.e., a vascular emergency, from 24.6% to 47.5% [ 12 ]. In contrast, in their evaluation of two large hospitals in the Netherlands, Exelmans et al observed no significant decrease in the number of patients treated throughout 2020, but a relative increase in higher PAD stages and acute limb ischemia with a subsequent increase in major amputations [ 15 ]. Thus, care for critically ill patients does not seem to be that compromised and the outcome acceptable?…”

Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on In-Patient Treatment of Peripheral Artery Disease in Germany during the First Pandemic Wave

Scheurig-Muenkler

Schwarz

Kröncke

et al. 2022

JCM

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Patients with peripheral artery disease (PAD) belong to a vulnerable population with relevant comorbidity. Appropriate care and timely treatment are imperative, but not readily assured in the current pandemic. What impact did the first wave have on in-hospital treatment in Germany? Nationwide healthcare remuneration data for inpatient care of the years 2019 and 2020 were used to compare demographic baseline data including the assessment of comorbidity (van Walraven score), as well as the encoded treatments. A direct comparison was made between the first wave of infections in 2020 and the reference period in 2019. The number of inpatient admissions decreased by 10.9%, with a relative increase in hospitalizations due to PAD Fontaine IV (+13.6%). Baseline demographics and comorbidity showed no relevant differences. The proportion of emergency admissions increased from 23.4% to 28.3% during the first wave to the reference period in 2019, and in-hospital mortality increased by 21.9% from 2.5% to 3.1%. Minor and major amputations increased by 24.5% and 18.5%. Endovascular and combined surgical/endovascular treatment strategies increased for all stages. Already in the first, comparatively mild wave of the pandemic, significantly fewer patients with predominantly higher-grade PAD stages were treated as inpatients. Consecutively, in-hospital mortality and amputation rates increased.

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Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on In-Patient Treatment of Peripheral Artery Disease in Germany during the First Pandemic Wave

Scheurig-Muenkler

Schwarz

Kröncke

et al. 2022

JCM

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Risk factors of postoperative intensive care unit admission during the COVID-19 pandemic: A multicentre retrospective cohort study

Bock

Filipe

Herman

et al. 2023

International Journal of Surgery Open

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Background During the Coronavirus disease 2019 (COVID-19) pandemic, intensive care unit (ICU) capacity was scarce. Since surgical patients also require ICU admission, determining which factors lead to an increased risk of postoperative ICU admission is essential. This study aims to determine which factors led to an increased risk of unplanned postoperative ICU admission during the COVID-19 pandemic. Methods This multicentre retrospective cohort study investigated all patients who underwent surgery between 9 March 2020 and 30 June 2020. The primary endpoint was the number of surgical patients requiring postoperative ICU admission. The secondary endpoint was to determine factors leading to an increased risk of unplanned postoperative ICU admission, calculated by multivariate analysis with odds ratios (OR’s) and 95% confidence (CI) intervals. Results One hundred eighty-five (4.6%) of the 4051 included patients required unplanned postoperative ICU admission. COVID-19 positive patients were at an increased risk of being admitted to the ICU compared to COVID-19 negative (OR 3.14; 95% CI 1.06–9.33; p = 0.040) and untested patients (OR 0.48; 95% CI 0.32–0.70; p = 0.001). Other predictors were male gender (OR 1.36; 95% CI 1.02–1.82; p = 0.046), body mass index (BMI) (OR 1.05; 95% CI 1.02–1.08; p = 0.001), surgical urgency and surgical discipline. Conclusion A confirmed COVID-19 infection, male gender, elevated BMI, surgical urgency, and surgical discipline were independent factors for an increased risk of unplanned postoperative ICU admission. In the event of similar pandemics, postponing surgery in patients with an increased risk of postoperative ICU admission may be considered. Highlights

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A review of disparities in peripheral artery disease and diabetes–related amputations during the COVID-19 pandemic

Pride

Kabeil

Alabi

et al. 2023

Seminars in Vascular Surgery

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Treating Peripheral Arterial Occlusive Disease and Acute Limb Ischemia During a COVID-19 Pandemic in 2020

Cited by 3 publications

References 14 publications

Impact of the COVID-19 Pandemic on In-Patient Treatment of Peripheral Artery Disease in Germany during the First Pandemic Wave

Impact of the COVID-19 Pandemic on In-Patient Treatment of Peripheral Artery Disease in Germany during the First Pandemic Wave

Risk factors of postoperative intensive care unit admission during the COVID-19 pandemic: A multicentre retrospective cohort study

A review of disparities in peripheral artery disease and diabetes–related amputations during the COVID-19 pandemic

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