Vascular Surgery, Cardiovascular Department, Poliambulanza Foundation, Brescia, Italy.
Vascular Surgery - Department of Medicine and Surgery, University of Insubria School of Medicine, ASST Settelaghi Circolo University Teaching Hospital, via F. Guicciardini 9, 21100, Varese, Italy.
Eur J Vasc Endovasc Surg. 2021 Apr;61(4):688-697. doi: 10.1016/j.ejvs.2021.01.037. Epub 2021 Mar 13.
The characteristics and outcomes of patients undergoing vascular surgery hospitalised and managed in Lombardy are described with a comparison of patients tested positive for COVID-19 (CV19-pos) vs. those tested negative (CV19-neg).
This was a multicentre, retrospective, observational cohort study which involved all vascular surgery services in Lombardy, Northern Italy. Data were retrospectively merged into a combined dataset covering the nine weeks of the Italian COVID-19 pandemic phase 1 (8 March 2020 to 3 May 2020). The primary outcome was freedom from in hospital death, secondary outcomes were re-thrombosis rate after peripheral revascularisation, and freedom from post-operative complication.
Among 674 patients managed during the outbreak, 659 (97.8%) were included in the final analysis: 121 (18.4%) were CV19-pos. CV19-pos status was associated with a higher rate of complications (OR 4.5; p < .001, 95% CI 2.64 - 7.84), and a higher rate of re-thrombosis after peripheral arterial revascularisation (OR 2.2; p = .004, 95% CI 1.29 - 3.88). In hospital mortality was higher in CV19-pos patients (24.8% vs. 5.6%; OR 5.4, p < .001;95% CI 2.86 - 8.92). Binary logistic regression analysis identified CV19-pos status (OR 7.6; p < .001, 95% CI 3.75 - 15.28) and age > 80 years (OR 3.2; p = .001, 95% CI 1.61 - 6.57) to be predictors of in hospital death.
In this experience of the vascular surgery group of Lombardy, COVID-19 infection was a marker of poor outcomes in terms of mortality and post-operative complications for patients undergoing vascular surgery treatments.
描述在伦巴第大区接受血管外科治疗和管理的患者的特征和结局，并将新冠病毒检测阳性（CV19-阳性）的患者与新冠病毒检测阴性（CV19-阴性）的患者进行比较。
这是一项多中心、回顾性、观察性队列研究，涉及意大利北部伦巴第大区的所有血管外科服务。数据被回顾性地合并到一个综合数据集，涵盖了意大利 COVID-19 大流行第一阶段的九周（2020 年 3 月 8 日至 2020 年 5 月 3 日）。主要结局是住院期间无死亡，次要结局是外周血运重建后的再血栓形成率，以及术后无并发症。
在疫情期间管理的 674 名患者中，有 659 名（97.8%）被纳入最终分析：121 名（18.4%）为 CV19-阳性。CV19-阳性状态与更高的并发症发生率（OR 4.5；p<.001，95%CI 2.64-7.84）和外周动脉血运重建后再血栓形成率（OR 2.2；p=.004，95%CI 1.29-3.88）相关。CV19-阳性患者的住院死亡率更高（24.8% vs. 5.6%；OR 5.4，p<.001；95%CI 2.86-8.92）。二元逻辑回归分析确定 CV19-阳性状态（OR 7.6；p<.001，95%CI 3.75-15.28）和年龄>80 岁（OR 3.2；p=.001，95%CI 1.61-6.57）是住院死亡的预测因素。
在伦巴第大区血管外科组的这一经验中，COVID-19 感染是血管外科治疗患者死亡和术后并发症不良结局的标志物。
