Regional Survey in Lombardy, Northern Italy, on Vascular Surgery Intervention Outcomes During The COVID-19 Pandemic

The Lombardy Covid-19 Vascular Study Group, R. Bellosta, G. Piffaretti, S. Bonardelli, P. Castelli, R. Chiesa, D. Frigerio, G. Lanza, S. Pirrelli, G. Rossi, S. Trimarchi

Research output: Contribution to journalArticlepeer-review

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 languageEnglish
Pages (from-to)688-697
Number of pages10
JournalEuropean Journal of Vascular and Endovascular Surgery
Volume61
Issue number4
DOIs
Publication statusPublished - 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

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