Abstract
Objective: 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). Methods: 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. Results: 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. Conclusion: 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.
Original language | English |
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Pages (from-to) | 688-697 |
Number of pages | 10 |
Journal | European Journal of Vascular and Endovascular Surgery |
Volume | 61 |
Issue number | 4 |
DOIs | |
Publication status | Published - 2021 |
Keywords
- acute limb ischaemia
- COVID-19
- vascular surgery activities
- acetylsalicylic acid
- anticoagulant agent
- antithrombocytic agent
- creatine kinase
- abdominal aortic aneurysm
- adult
- adult respiratory distress syndrome
- aged
- aortic aneurysm
- aortic dissection
- Article
- carotid artery disease
- carotid artery stenting
- carotid endarterectomy
- cause of death
- clinical evaluation
- clinical outcome
- cohort analysis
- comparative study
- controlled study
- coronavirus disease 2019
- data analysis software
- disease association
- endovascular aneurysm repair
- female
- gangrene
- health survey
- hospital mortality
- hospitalization
- human
- Italy
- kidney disease
- lung embolism
- major clinical study
- male
- managed care
- middle aged
- mortality rate
- multicenter study (topic)
- multiple organ failure
- observational study
- pandemic
- percutaneous transluminal angioplasty
- peripheral occlusive artery disease
- postoperative complication
- postoperative hemorrhage
- priority journal
- retrospective study
- revascularization
- sepsis
- spinal cord ischemia
- surgical thrombectomy
- thoracoabdominal aorta aneurysm
- thrombosis
- vascular surgery
- very elderly
- clinical trial
- health care survey
- multicenter study
- treatment outcome
- Aged
- Aged, 80 and over
- Cohort Studies
- Female
- Health Care Surveys
- Humans
- Male
- Middle Aged
- Postoperative Complications
- Retrospective Studies
- Treatment Outcome
- Vascular Surgical Procedures