Dissecting the Management and Outcomes of Thoracic Aortovascular Disease During the COVID-19 Pandemic
| Autor: | Karen Booth, Kathrin Freystaetter, Robin Williams, Sandip Nandhra, Ashwin Sivaharan, Mazyar Kanani, Iain McPherson, Nicholas Chilvers, James McCaslin |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Time Factors Databases Factual CAD coronary artery disease Prospective data Aorta Thoracic AGP aerosol generating procedure Disease 030204 cardiovascular system & hematology 030218 nuclear medicine & medical imaging law.invention COVID-19 Testing Postoperative Complications 0302 clinical medicine Risk Factors law SCI spinal cord ischaemia LVEF left ventricular ejection fraction Pandemic Medicine Hospital Mortality Prospective Studies Spinal cord injury Stroke Aged 80 and over General Medicine Middle Aged ICU intensive care unit NCEPOD national confidential enquiry into patient outcome and death Intensive care unit Treatment Outcome England MI myocardial infarction Female Patient Safety Cardiology and Cardiovascular Medicine Vascular Surgical Procedures medicine.medical_specialty Coronavirus disease 2019 (COVID-19) Aortic Diseases NYHA New York heart association Risk Assessment Clinical Research Basic Science 03 medical and health sciences Euroscore ii Humans Aged business.industry COVID-19 Length of Stay medicine.disease SOP standard operating procedure Emergency medicine Surgery business |
| Zdroj: | Annals of Vascular Surgery |
| ISSN: | 0890-5096 |
| DOI: | 10.1016/j.avsg.2021.04.008 |
| Popis: | Objective The COVID-19 pandemic has forced the cancellation of planned surgery and led to significant surgical service reductions. Early intervention in aortovascular disease is often critical and cannot be deferred despite these reductions. There is urgent need to evaluate the provision and outcomes of thoracic aortovascular intervention during the peak of the pandemic. Methods Prospective data was collected for patients receiving open and endovascular thoracic aortovascular intervention over two-time points; January-May 2020 and January-May 2019 at three tertiary cardiovascular centres. Baseline demographics, cardiovascular risk and COVID-19 screening results were noted. Primary outcomes were median length of intensive care unit and hospital stay, intra-operative mortality, 30-day mortality, post-operative stroke, and spinal cord injury. Results Patients operated in 2020 (41) had significantly higher median EuroSCORE II than 2019 (53) (7.44 vs. 5.86, P = 0.032) and rates of previous cardiac (19.5% vs. 3.8%, P = 0.019), aortic (14.6% vs. 1.9%, P = 0.041), and endovascular (22.0% vs. 3.8%, P = 0.009) intervention. There was an increase in proportion of urgent cases in 2020 (31.7% vs. 18.9%). There were no intra-operative deaths in 2020 and 1 in 2019 (P = 1.00). There were no significant differences (P ≥ 0.05) in 30-day mortality (4.9% vs. 13.2%), median intensive care unit length of stay (72 vs. 70 hr), median hospital length of stay (8 vs. 9 days), post-operative stroke (3 vs. 6), or spinal cord injury (2 vs. 1) between 2020 and 2019 respectively. Conclusions Despite the increased mortality risk of patients and urgency of cases during COVID-19, complicated by the introduction of cohorting and screening regimens, thoracic aortovascular intervention remained safe with comparable in outcomes to pre-COVID-19. |
| Databáze: | OpenAIRE |
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