Feinberg School of Medicine, Northwestern University, Chicago, Ill.
College of Medicine, Northeast Ohio Medical University, Rootstown, Ohio.
J Vasc Surg Venous Lymphat Disord. 2021 Sep;9(5):1093-1098. doi: 10.1016/j.jvsv.2021.01.002. Epub 2021 Jan 20.
In response to the pandemic, an abrupt pivot of Vascular Quality Initiative physician members away from standard clinical practice to a restrictive phase of emergent and urgent vascular procedures occurred. The Society for Vascular Surgery Patient Safety Organization queried both data managers and physicians in May 2020. Approximately three-fourths (74%) of physicians adopted restrictive operating policies for urgent and emergent cases only, whereas one-half proceeded with "time sensitive" elective cases as urgent. Data manager case entry was negatively affected by both low case volumes and staffing due to reassignment or furlough. Venous registry volumes were reduced fivefold in the first quarter of 2020 compared with a similar period in 2019. The consequences of delaying vascular procedures for ambulatory venous practice remain unknown with increased morbidity likely. Challenges to determine venous thromboembolism mortality impact exist given difficulty in verifying "in home and extended care facility" deaths. Further ramifications of a pandemic shutdown will likely be amplified if postponement of elective vascular care extends beyond a short window of time. It will be important to monitor disease progression and case severity as a result of policy shifts adopted locally in response to pandemic surges.
针对疫情,血管质量倡议的医生成员突然从标准临床实践转向紧急和紧急血管手术的限制阶段。血管外科学会患者安全组织于 2020 年 5 月向数据管理员和医生进行了查询。大约四分之三(74%)的医生仅对紧急和紧急情况采用限制手术政策,而一半则将“时间敏感”的择期病例视为紧急情况。由于重新分配或休假,数据管理员的病例输入受到低病例量和人员配置的负面影响。与 2019 年同期相比,2020 年第一季度静脉登记册数量减少了五倍。由于发病率可能增加,延迟门诊静脉手术的后果仍不得而知。由于难以核实“在家和延长护理设施”的死亡情况,因此确定静脉血栓栓塞死亡率影响存在挑战。如果 elective 血管护理的推迟时间超过短时间窗口,大流行关闭的进一步影响可能会放大。由于针对大流行激增而在当地采用的政策转变,监测疾病进展和病例严重程度将非常重要。