Division of Vascular & Endovascular Surgery, McLaren Health System, Bay City, Mich; Division of Vascular Surgery, Michigan State University, Lansing, Mich.
Division of Vascular Surgery, University of California Los Angeles, Los Angeles, Calif.
J Vasc Surg. 2021 Mar;73(3):772-779.e4. doi: 10.1016/j.jvs.2020.08.036. Epub 2020 Sep 1.
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.
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 to 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, elective surgical practice, changes in call schedule, and redeployment to nonvascular surgery duties were also included in the survey. Regional variation was assessed. The survey data were collected using REDCap and analyzed using descriptive statistics.
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 one-half were in hospitals with more than 400 beds (46.4%). There was no regional variation in the presence of preoperative COVID-19 testing, COVID-19 OR protocols, adherence to national surgical standards, or the availability of personal protective equipment. 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 or 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. More than one-half of office-based laboratories (OBLs) were closed, although there was regional variation with more than 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%).
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 use, intensive care bed availability, and COVID-19 exposure at work.
2019 年冠状病毒病（COVID-19）大流行导致美国广泛推迟和取消择期手术。我们设计并进行了一项全球调查，以检查 COVID-19 对血管外科医生的影响。我们描述了大流行对美国血管外科医生实践的影响。
《COVID-19 大流行对血管外科医生实践、焦虑、应对和支持的影响调查》是一项由血管外科学会健康工作组成员发起的匿名横断面调查，于 2020 年 4 月 14 日至 24 日发布。本分析重点关注美国血管外科实践模式的变化，包括住院、门诊和血管实验室环境。调查还包括有关 COVID-19 职业暴露、个人防护设备充足性、择期手术实践、呼叫时间表变化以及重新部署至非血管外科手术职责等方面的具体问题。评估了区域差异。使用 REDCap 收集调查数据，并使用描述性统计进行分析。
共有 535 名血管外科医生从 45 个州对调查做出回应。大多数受访者为男性（73.1%），白人（70.7%），在城市环境中工作（81.7%），在教学医院工作（66.8%）。近一半（46.4%）的人在拥有 400 多张床位的医院工作。在术前 COVID-19 检测、COVID-19 手术室规程、遵守国家手术标准或个人防护设备的可用性方面，没有地区差异。绝大多数受访者（91.7%）表示取消了择期手术，东北和东南地区取消的病例最多，分别为 94.2%和 95.8%。东北地区报告有 COVID-19 患者的手术或操作比例最高，这些患者要么在手术时被发现，要么在住院期间被发现（82.7%）。门诊就诊通过远程医疗进行（81.3%），其中 71.1%限制了就诊时间。尽管中西部地区有超过 80%的办公室实验室（OBL）关闭，但超过一半的 OBL 关闭。在 OBL 进行的手术主要针对严重肢体缺血（42.9%）和透析通路维护（39.9%）。尽管改变了呼叫时间表，但呼叫天数保持不变（45.8%）。
美国的血管外科医生报告说，在 COVID-19 大流行期间，他们的实践受到了重大影响，并且显示出区域差异，特别是在 OBL 使用、重症监护床位可用性和工作中的 COVID-19 暴露方面。
