Noory Elias, Böhme Tanja, Salm Jonas, Beschorner Ulrich, Westermann Dirk, Zeller Thomas
Clinic for Cardiology and Angiology, University Heart Center Freiburg-Bad Krozingen, Campus Bad Krozingen, Südring 15, 79189 Bad Krozingen, Germany.
J Clin Med. 2023 Jan 23;12(3):890. doi: 10.3390/jcm12030890.
To better manage the burden of the COVID-19 pandemic on hospitals, numerous scheduled procedures have been postponed nationwide.
Retrospective analysis of patient characteristics and outcomes of patients hospitalized with peripheral arterial disease (PAD) in the period prior to the COVID-19 pandemic (2018 and 2019) and during the pandemic (2020 and 2021). This study assesses the in-hospital outcomes. Main endpoints are Rutherford stages at admission for intervention, incidence of amputation, of total occlusion, and duration of intervention. The data were analyzed descriptively.
The total number of interventions due to PAD had decreased in 2020, but not significantly during the pandemic period ( = 5351) compared to the period prior to COVID-19 pandemic ( = 5351) ( = 0.589). The proportion of interventions treated for critical limb-threatening ischaemia (CLTI) increased from 2018/2019 ( = 2112) to 2020/2021 ( = 2426) ( < 0.001). However, the proportion of patients with wounds requiring amputation was not higher during the pandemic ( = 191) than before ( = 176) (minor amputations = 0.2302, major amputations = 0.9803). The proportion of total occlusions did not differ significantly between the pre-COVID-19 ( = 3082) and the COVID-19 pandemic periods ( = 2996) ( = 0.8207). Multilevel interventions did not increase significantly from 2018/2019 ( = 1930) to 2020/2021 ( = 2071). Between 2018/2019 and 2020/2021, the procedure duration and fluoroscopy duration increased significantly. However, parameters such as contrast agent volume and radiation dose did not differ significantly. The average length of stay was 4.6 days.
The COVID-19 pandemic had an impact on the in-patient care of PAD patients in terms of disease stage severity and complexity. However, the amputation rate was not affected.
为了更好地应对新冠疫情给医院带来的负担，全国范围内许多预定手术都被推迟。
对在新冠疫情之前（2018年和2019年）以及疫情期间（2020年和2021年）因外周动脉疾病（PAD）住院的患者的特征和结局进行回顾性分析。本研究评估住院结局。主要终点为干预入院时的卢瑟福分期、截肢发生率、完全闭塞发生率以及干预持续时间。对数据进行描述性分析。
2020年因PAD进行的干预总数有所下降，但与新冠疫情之前相比，疫情期间（n = 5351）并无显著差异（n = 5351）（P = 0.589）。因严重肢体缺血（CLTI）接受治疗的干预比例从2018/2019年（n = 2112）增加到2020/2021年（n = 2426）（P < 0.001）。然而，疫情期间需要截肢的伤口患者比例（n = 191）并不高于之前（n = 176）（小截肢P = 0.2302，大截肢P = 0.9803）。完全闭塞的比例在新冠疫情之前（n = 3082）和新冠疫情期间（n = 2996）没有显著差异（P = 0.8207）。从2018/2019年（n = 1930）到2020/2021年（n = 2071），多级干预没有显著增加。在2018/2019年和2020/2021年之间，手术持续时间和透视持续时间显著增加。然而，造影剂用量和辐射剂量等参数没有显著差异。平均住院时间为4.6天。
新冠疫情在疾病阶段的严重程度和复杂性方面对外周动脉疾病患者的住院护理产生了影响。然而，截肢率并未受到影响。
