PMID- 33592408
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231110
IS  - 2210-2612 (Print)
IS  - 2210-2612 (Electronic)
IS  - 2210-2612 (Linking)
VI  - 80
DP  - 2021 Mar
TI  - Impact of the COVID-19 pandemic on the management of chronic limb-threatening 
      ischemia in Northern Jordan: Case series and literature review.
PG  - 105631
LID - S2210-2612(21)00127-9 [pii]
LID - 10.1016/j.ijscr.2021.02.017 [doi]
LID - 105631
AB  - INTRODUCTION: The novel COVID-19 pandemic has imposed unprecedented restrictions 
      on healthcare services worldwide. In developing nations such as Jordan, 
      appreciable impacts on healthcare delivery ensued owing to limited resources. As 
      a result, managing chronic limb-threatening ischemia (CLTI) has been modified to 
      accommodate altercations in the system. This study assessed the impact of the 
      COVID-19 pandemic on managing patients with critical limb-threatening ischemia 
      (CLTI) during the lockdown. METHODS: Objectives were accomplished by retrieving 
      records of clinical data and perioperative results for patients diagnosed with 
      CLTI at King Abdullah University Hospital between March 17 and June 1, 2020. 
      Patients' demographics, Rutherford classification, type of intervention, and 
      intervention variables during the outbreak were retrospectively analyzed 
      (pandemic Group A) and compared with patients from the same period last year 
      (control Group B). RESULTS: A total of 96 patients with CLTI were included in the 
      study; Groups A and B consisted of 28 and 68 patients, respectively. The mean 
      ages for Groups A and B were 62.8 and 60.2 years, respectively. Conservative 
      management was applied to 53.6% (P < 0.01) of Group A patients, whereas 
      endovascular revascularization was the primary approach in Group B (39.7%, P < 
      0.01). After the intervention, the majority of patients in Group A were 
      classified as category six on the Rutherford classification system (46.4%, P < 
      0.01), whereas the majority in group B were classified as category five (55.9%, P 
      < 0.01). CONCLUSIONS: The more unsatisfactory outcome of CLTI during the pandemic 
      entails substantial measures to ensure conscientious virtual encounters and 
      ambulatory community-based services during current and future pandemics. The 
      endovascular-first policy should be endorsed in future pandemics as it is better 
      at reducing aerosol transmission than standard surgical intervention. Moreover, 
      endovascular procedures are minimally invasive and associated with favorable 
      outcomes when medical optimization and hospital beds are limited.
CI  - Copyright (c) 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.
FAU - Aljarrah, Qusai
AU  - Aljarrah Q
AD  - Department of General Surgery & Vascular Surgery, Faculty of Medicine, Jordan 
      University of Science and Technology, Irbid, 22110, Jordan. Electronic address: 
      qmaljarrah@just.edu.jo.
FAU - Allouh, Mohammed
AU  - Allouh M
AD  - Department of Anatomy, College of Medicine and Health Sciences, United Arab 
      Emirates University, Al Ain, 17666, United Arab Emirates; Department of Anatomy, 
      Faculty of Medicine, Jordan University of Science and Technology, Irbid, 22110, 
      Jordan.
FAU - Hallak, Amer
AU  - Hallak A
AD  - Department of General Surgery & Vascular Surgery, Faculty of Medicine, Jordan 
      University of Science and Technology, Irbid, 22110, Jordan.
FAU - Al-Omari, Mamoon
AU  - Al-Omari M
AD  - Department of Diagnostic and Interventional Radiology, Faculty of Medicine, 
      Jordan University of Science and Technology, Irbid, 22110, Jordan.
FAU - Mesmar, Zaid
AU  - Mesmar Z
AD  - Department of General Surgery & Vascular Surgery, Faculty of Medicine, Jordan 
      University of Science and Technology, Irbid, 22110, Jordan.
FAU - Kamel, Ahmad
AU  - Kamel A
AD  - Department of General Surgery & Vascular Surgery, Faculty of Medicine, Jordan 
      University of Science and Technology, Irbid, 22110, Jordan.
FAU - Husein, Anas
AU  - Husein A
AD  - Department of General Surgery & Vascular Surgery, Faculty of Medicine, Jordan 
      University of Science and Technology, Irbid, 22110, Jordan.
FAU - Manasreh, Tarek
AU  - Manasreh T
AD  - Department of General Surgery & Vascular Surgery, Faculty of Medicine, Jordan 
      University of Science and Technology, Irbid, 22110, Jordan.
FAU - Bakkar, Sohail
AU  - Bakkar S
AD  - Department of Surgery, Faculty of Medicine, the Hashemite University, Zarqa, 
      13133, Jordan.
FAU - Jarboa, Hamza
AU  - Jarboa H
AD  - Department of General Surgery & Vascular Surgery, Faculty of Medicine, Jordan 
      University of Science and Technology, Irbid, 22110, Jordan.
LA  - eng
PT  - Journal Article
DEP - 20210209
PL  - Netherlands
TA  - Int J Surg Case Rep
JT  - International journal of surgery case reports
JID - 101529872
PMC - PMC7893439
OTO - NOTNLM
OT  - COVID-19
OT  - Chronic limb-threatening ischemia
OT  - Conservative management
OT  - Revascularization
EDAT- 2021/02/17 06:00
MHDA- 2021/02/17 06:01
PMCR- 2021/02/09
CRDT- 2021/02/16 20:11
PHST- 2021/01/13 00:00 [received]
PHST- 2021/02/04 00:00 [revised]
PHST- 2021/02/04 00:00 [accepted]
PHST- 2021/02/17 06:00 [pubmed]
PHST- 2021/02/17 06:01 [medline]
PHST- 2021/02/16 20:11 [entrez]
PHST- 2021/02/09 00:00 [pmc-release]
AID - S2210-2612(21)00127-9 [pii]
AID - 105631 [pii]
AID - 10.1016/j.ijscr.2021.02.017 [doi]
PST - ppublish
SO  - Int J Surg Case Rep. 2021 Mar;80:105631. doi: 10.1016/j.ijscr.2021.02.017. Epub 
      2021 Feb 9.