PMID- 34169796
OWN - NLM
STAT- MEDLINE
DCOM- 20211220
LR  - 20221207
IS  - 1477-0377 (Electronic)
IS  - 1358-863X (Linking)
VI  - 26
IP  - 6
DP  - 2021 Dec
TI  - North American lower-extremity revascularization and amputation during COVID-19: 
      Observations from the Vascular Quality Initiative.
PG  - 613-623
LID - 10.1177/1358863X211021918 [doi]
AB  - INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic's impact on 
      vascular procedural volumes and outcomes has not been fully characterized. 
      METHODS: Volume and outcome data before (1/2019 - 2/2020), during (3/2020 - 
      4/2020), and following (5/2020 - 6/2020) the initial pandemic surge were obtained 
      from the Vascular Quality Initiative (VQI). Volume changes were determined using 
      interrupted Poisson time series regression. Adjusted mortality was estimated 
      using multivariable logistic regression. RESULTS: The final cohort comprised 
      57,181 patients from 147 US and Canadian sites. Overall procedure volumes fell 
      35.2% (95% CI 31.9%, 38.4%, p < 0.001) during and 19.8% (95% CI 16.8%, 22.9%, p < 
      0.001) following the surge, compared with presurge months. Procedure volumes fell 
      71.1% for claudication (95% CI 55.6%, 86.4%, p < 0.001) and 15.9% for chronic 
      limb-threatening ischemia (CLTI) (95% CI 11.9%, 19.8%, p < 0.001) but remained 
      unchanged for acute limb ischemia (ALI) when comparing surge to presurge months. 
      Adjusted mortality was significantly higher among those with claudication (0.5% 
      vs 0.1%; OR 4.38 [95% CI 1.42, 13.5], p = 0.01) and ALI (6.4% vs 4.4%; OR 2.63 
      [95% CI 1.39, 4.98], p = 0.003) when comparing postsurge with presurge periods. 
      CONCLUSION: The first North American COVID-19 pandemic surge was associated with 
      a significant and sustained decline in both elective and nonelective 
      lower-extremity vascular procedural volumes. When compared with presurge 
      patients, in-hospital mortality increased for those with claudication and ALI 
      following the surge.
FAU - Lou, Jun-Yang
AU  - Lou JY
AUID- ORCID: 0000-0003-2628-1288
AD  - Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard 
      Medical School, Boston, MA, USA.
FAU - Kennedy, Kevin F
AU  - Kennedy KF
AD  - Independent statistical Consultant, Kansas City, MO, USA.
FAU - Menard, Matthew T
AU  - Menard MT
AD  - Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, 
      Harvard Medical School, Boston, MA, USA.
FAU - Abbott, J Dawn
AU  - Abbott JD
AD  - Division of Cardiology, Alpert Medical School of Brown University, Providence, 
      RI, USA.
FAU - Secemsky, Eric A
AU  - Secemsky EA
AUID- ORCID: 0000-0003-3861-3163
AD  - Department of Medicine, Division of Cardiology, Beth Israel Deaconess Medical 
      Center, Harvard Medical School, Boston, MA, USA.
FAU - Goodney, Philip P
AU  - Goodney PP
AD  - Section of Vascular Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH, 
      USA.
FAU - Saad, Marwan
AU  - Saad M
AD  - Division of Cardiology, Alpert Medical School of Brown University, Providence, 
      RI, USA.
FAU - Soukas, Peter A
AU  - Soukas PA
AD  - Division of Cardiology, Alpert Medical School of Brown University, Providence, 
      RI, USA.
FAU - Hyder, Omar N
AU  - Hyder ON
AD  - Division of Cardiology, Alpert Medical School of Brown University, Providence, 
      RI, USA.
FAU - Aronow, Herbert D
AU  - Aronow HD
AUID- ORCID: 0000-0002-9061-7893
AD  - Division of Cardiology, Alpert Medical School of Brown University, Providence, 
      RI, USA.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20210625
PL  - England
TA  - Vasc Med
JT  - Vascular medicine (London, England)
JID - 9610930
SB  - IM
CIN - Vasc Med. 2021 Dec;26(6):624-625. PMID: 34380346
MH  - *Amputation, Surgical
MH  - *COVID-19/epidemiology
MH  - Canada/epidemiology
MH  - Chronic Limb-Threatening Ischemia
MH  - Endovascular Procedures/*methods
MH  - Humans
MH  - Limb Salvage
MH  - Lower Extremity
MH  - Pandemics
MH  - Peripheral Arterial Disease/diagnosis/epidemiology/*surgery
MH  - Retrospective Studies
MH  - Risk Factors
MH  - SARS-CoV-2
MH  - Time Factors
MH  - Treatment Outcome
OTO - NOTNLM
OT  - COVID-19
OT  - endovascular therapy
OT  - peripheral artery disease (PAD)
OT  - registries
OT  - vascular surgery
EDAT- 2021/06/26 06:00
MHDA- 2021/12/21 06:00
CRDT- 2021/06/25 08:40
PHST- 2021/06/26 06:00 [pubmed]
PHST- 2021/12/21 06:00 [medline]
PHST- 2021/06/25 08:40 [entrez]
AID - 10.1177/1358863X211021918 [doi]
PST - ppublish
SO  - Vasc Med. 2021 Dec;26(6):613-623. doi: 10.1177/1358863X211021918. Epub 2021 Jun 
      25.