Vascular and Endovascular Surgery Unit, Ospedale Policlinico San Martino - IRCCS, Genoa, Italy; Department of Surgical Sciences and Integrated Diagnostic (DISC), University of Genoa, Genoa, Italy.
Vascular and Endovascular Surgery Unit, Ospedale Policlinico San Martino - IRCCS, Genoa, Italy; Department of Surgical Sciences and Integrated Diagnostic (DISC), University of Genoa, Genoa, Italy.
Ann Vasc Surg. 2021 Jul;74:73-79. doi: 10.1016/j.avsg.2021.01.072. Epub 2021 Feb 5.
The aim of the study is to evaluate the impact of COVID-19 pandemic on vascular surgery practice in a regional hub center for complex vascular disease.
This is an observational single-center study in which we collected clinical and surgical data during (P1) and after (P2) the COVID-19 outbreak and the lockdown measures implemented in Northern Italy. We compared those data with the two-month period before the pandemic (P0).
Compared to P0, ambulatory activities were severely reduced during P1 and limited to hospitalized patients and outpatients with urgent criteria. We performed 61 operations (18 urgent and 43 elective), with a decrease in both aortic (-17.8%), cerebrovascular (-53.3%), and peripheral artery (-42.6%) disease treatments. We also observed a greater drop in open procedures (-53.2%) than in endovascular ones (-22%). All the elective patients were treated for notdeferrable conditions and they were COVID-19 negative at the ward admission screening; despite this one of them developed COVID19 during the hospital stay. Four COVID-19 positive patients were treated in urgent setting for acute limb ischemia. Throughout P2 we gradually rescheduled elective ambulatory (+155.5%) and surgical (+18%) activities, while remaining substantially lower than during P0 (respectively -45.6% and -25.7%).
Despite COVID-19 pandemic, our experience shows that with careful patient's selection, dedicated prehospitalization protocol and proper use of personal protective equipment it is possible to guarantee continuity of care.
本研究旨在评估 COVID-19 大流行对复杂血管疾病区域中心血管外科实践的影响。
这是一项观察性单中心研究，我们在 COVID-19 爆发和意大利北部实施封锁措施期间（P1）和之后（P2）收集临床和手术数据，并将这些数据与大流行前两个月（P0）的数据进行比较。
与 P0 相比，P1 期间门诊活动严重减少，仅限于住院患者和有紧急标准的门诊患者。我们进行了 61 例手术（18 例紧急手术和 43 例择期手术），主动脉疾病（-17.8%）、脑血管疾病（-53.3%）和外周动脉疾病（-42.6%）的治疗均减少。我们还观察到开放手术（-53.2%）的降幅大于血管内手术（-22%）。所有择期手术的患者均接受不可推迟的治疗，且在入院筛查时 COVID-19 检测均为阴性；尽管如此，其中一人在住院期间感染 COVID19。4 例 COVID-19 阳性患者因急性肢体缺血在紧急情况下接受治疗。在整个 P2 期间，我们逐渐增加了门诊择期手术（增加 155.5%）和手术（增加 18%）的数量，但仍远低于 P0 时的水平（分别为-45.6%和-25.7%）。
尽管发生了 COVID-19 大流行，但我们的经验表明，通过仔细选择患者、制定专门的院前协议和正确使用个人防护设备，可以保证护理的连续性。
