Outcomes After Vascular Surgery Procedures in Patients with COVID-19 Infection: A National Multicenter Cohort Study (COVID-VAS).

Autor:	San Norberto EM; Department of Vascular Surgery, Valladolid University Hospital, Valladolid, Spain. Electronic address: esannorberto@hotmail.com., De Haro J; Department of Vascular Surgery, Getafe University Hospital, Madrid, Spain., Peña R; Department of Vascular Surgery, Salamanca University Hospital, Salamanca, Spain., Riera L; Department of Vascular Surgery, La Paz University Hospital, Madrid, Spain., Fernández-Caballero D; Department of Vascular Surgery, Torrejón University Hospital, Madrid, Spain., Sesma A; Department of Vascular Surgery, Álava. University Hospital, Álava, Spain., Rodríguez-Cabeza P; Department of Vascular Surgery, Dr. Josep Trueta University Hospital, Gerona, Spain., Ballesteros M; Department of Vascular Surgery, León University Hospital, León, Spain., Gómez-Jabalera E; Department of Vascular Surgery, Nostra Senyora de Meritxell Hospital, Andorra., Taneva GT; Department of Vascular Surgery, HM Hospitals, Madrid, Spain., Aparicio C; Department of Vascular Surgery, Jiménez Diaz Foundation University Hospital, Madrid, Spain., Moradillo N; Department of Vascular Surgery, Burgos University Hospital, Burgos, Spain., Soguero I; Department of Vascular Surgery, Miguel Servet University Hospital, Zaragoza, Spain., Badrenas AM; Department of Vascular Surgery, Xarxa Assistencial Universitària Manresa, Barcelona, Spain., Lara R; Department of Vascular Surgery, Son Espases University Hospital, Palma de Mallorca, Spain., Torres A; Department of Vascular Surgery, La Fe University Hospital, Valencia, Spain., Sala VA; Department of Vascular Surgery, Clinic University Hospital, Valencia, Spain., Vaquero C; Department of Vascular Surgery, Valladolid University Hospital, Valladolid, Spain.
Jazyk:	angličtina
Zdroj:	Annals of vascular surgery [Ann Vasc Surg] 2021 May; Vol. 73, pp. 86-96. Date of Electronic Publication: 2021 Jan 22.
DOI:	10.1016/j.avsg.2021.01.054
Abstrakt:	Objectives: To analyze the outcome of vascular procedures performed in patients with COVID-19 infection during the 2020 pandemic. Methods: This is a multicenter, prospective observational cohort study. We analyzed data from 75 patients with COVID-19 infection undergoing vascular surgery procedures in 17 hospitals across Spain and Andorra between March and May 2020. The primary end point was 30-day mortality. Clinical Trials registry number NCT04333693. Results: The mean age was 70.9 (45-94) and 58 (77.0%) patients were male. Around 70.7% had postoperative complications, 36.0% of patients experienced respiratory failure, 22.7% acute renal failure, and 22.7% acute respiratory distress syndrome (ARDS). All-cause 30-days mortality rate was 37.3%. Multivariate analysis identified age >65 years (P = 0.009), American Society of Anesthesiologists (ASA) classification IV (P = 0.004), preoperative lymphocyte count <0.6 (×10 9 /L) (P = 0.001) and lactate dehydrogenase (LDH) >500 (UI/L) (P = 0.004), need for invasive ventilation (P = 0.043), postoperative acute renal failure (P = 0.001), ARDS (P = 0.003) and major amputation (P = 0.009) as independent variables associated with mortality. Preoperative coma (P = 0.001), quick Sepsis Related Organ Failure Assessment (qSOFA) score ≥2 (P = 0.043), lymphocytes <0.6 (×10 9 /L) (P = 0.019) leucocytes >11.5 (×10 9 /L) (P = 0.007) and serum ferritin >1800 mg/dL (P = 0.004), bilateral lung infiltrates on thorax computed tomography (P = 0.025), and postoperative acute renal failure (P = 0.009) increased the risk of postoperative ARDS. qSOFA score ≥2 was the only risk factor associated with postoperative sepsis (P = 0.041). Conclusions: Patients with COVID-19 infection undergoing vascular surgery procedures showed poor 30-days survival. Age >65 years, preoperative lymphocytes <0.6 (x10 9 /L) and LDH >500 (UI/L), and postoperative acute renal failure, ARDS and need for major amputation were identified as prognostic factors of 30-days mortality. (Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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