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一项在意大利坎帕尼亚评估 COVID-19 爆发期间慢性肢体威胁性缺血住院率的横断面研究。

A cross-sectional study evaluating hospitalization rates for chronic limb-threatening ischemia during the COVID-19 outbreak in Campania, Italy.

机构信息

Department of Advanced Biomedical Sciences, Division of Cardiology, University of Naples Federico II, Naples, Italy.

Department of Vascular and Endovascular Surgery, AOU San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy.

出版信息

Vasc Med. 2021 Apr;26(2):174-179. doi: 10.1177/1358863X20977678. Epub 2020 Dec 17.

Abstract

The expansion of coronavirus disease 2019 (COVID-19) prompted measures of disease containment by the Italian government with a national lockdown on March 9, 2020. The purpose of this study is to evaluate the rate of hospitalization and mode of in-hospital treatment of patients with chronic limb-threatening ischemia (CLTI) before and during lockdown in the Campania region of Italy. The study population includes all patients with CLTI hospitalized in Campania over a 10-week period: 5 weeks before and 5 weeks during lockdown ( = 453). Patients were treated medically and/or underwent urgent revascularization and/or major amputation of the lower extremities. Mean age was 69.2 ± 10.6 years and 27.6% of the patients were women. During hospitalization, 21.9% of patients were treated medically, 78.1% underwent revascularization, and 17.4% required amputations. In the weeks during the lockdown, a reduced rate of hospitalization for CLTI was observed compared with the weeks before lockdown (25 vs 74/100,000 inhabitants/year; incidence rate ratio: 0.34, 95% CI 0.32-0.37). This effect persisted to the end of the study period. An increased amputation rate in the weeks during lockdown was observed (29.3% vs 13.4%; < 0.001). This study reports a reduced rate of CLTI-related hospitalization and an increased in-hospital amputation rate during lockdown in Campania. Ensuring appropriate treatment for patients with CLTI should be prioritized, even during disease containment measures due to the COVID-19 pandemic or other similar conditions.

摘要

2019 年冠状病毒病(COVID-19)的爆发促使意大利政府采取了疾病控制措施,于 2020 年 3 月 9 日实施了全国封锁。本研究旨在评估意大利坎帕尼亚地区封锁前后慢性肢体威胁性缺血(CLTI)患者的住院率和住院治疗方式。研究人群包括坎帕尼亚地区在 10 周内住院的所有 CLTI 患者:封锁前 5 周和封锁期间 5 周(=453)。患者接受药物治疗和/或紧急血运重建和/或下肢大截肢。平均年龄为 69.2±10.6 岁,27.6%的患者为女性。住院期间,21.9%的患者接受药物治疗,78.1%的患者接受血运重建,17.4%的患者需要截肢。与封锁前相比,封锁期间 CLTI 的住院率降低(25 例与 74/100,000 居民/年;发病率比:0.34,95%CI 0.32-0.37)。这种影响一直持续到研究结束。在封锁期间,截肢率增加(29.3%与 13.4%;<0.001)。本研究报告了在坎帕尼亚封锁期间 CLTI 相关住院率降低和住院期间截肢率增加。即使在 COVID-19 大流行或其他类似情况下采取疾病控制措施,也应优先考虑为 CLTI 患者提供适当的治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6cfa/8033437/1c8fb9a59777/10.1177_1358863X20977678-fig1.jpg

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