PMID- 37023916
OWN - NLM
STAT- MEDLINE
DCOM- 20230619
LR  - 20230619
IS  - 1615-5947 (Electronic)
IS  - 0890-5096 (Print)
IS  - 0890-5096 (Linking)
VI  - 93
DP  - 2023 Jul
TI  - The Impact of the COVID-19 Pandemic on a Dedicated Vascular Emergency Clinic.
PG  - 157-165
LID - S0890-5096(23)00190-5 [pii]
LID - 10.1016/j.avsg.2023.03.032 [doi]
AB  - BACKGROUND: Vascular Emergency Clinics (VEC) improve patient outcomes in chronic 
      limb-threatening ischemia (CLTI). They provide a "1 stop" open access policy, 
      whereby "suspicion of CLTI" by a healthcare professional or patient leads to a 
      direct review. We assessed the resilience of the outpatient VEC model to the 
      first year of the coronavirus disease (COVID-19) pandemic. METHODS: A 
      retrospective review of a prospectively maintained database of all patients 
      assessed in our VEC for lower limb pathologies between March 2020 and April 2021 
      was performed. This was cross-referenced to national and loco-regional 
      Governmental COVID-19 data. Individuals with CLTI were further analysed to 
      determine Peripheral Arterial Disease-Quality Improvement Framework compliance. 
      RESULTS: Seven hundred and ninety one patients attended for 1,084 assessments 
      (Male n = 484, 61%; Age 72.5 +/- standard deviation 12.2 years; White British 
      n = 645, 81.7%). In total, 322 patients were diagnosed with CLTI (40.7%). A total 
      of 188 individuals (58.6%) underwent a first revascularization strategy 
      (Endovascular n = 128, 39.8%; Hybrid n = 41, 12.7%; Open surgery n = 19, 5.9%; 
      Conservative n = 134, 41.6%). Major lower limb amputation rate was 10.9% (n = 35) 
      and mortality rate was 25.8% (n = 83) at 12 months of follow-up. Median referral 
      to assessment time was 3 days (interquartile range: 1-5). For the nonadmitted 
      patient with CLTI, the median assessment to intervention was 8 days 
      (interquartile range: 6-15) and median referral to intervention time of 11 days 
      (11-18). CONCLUSIONS: The VEC model has demonstrated strong resilience to the 
      COVID-19 pandemic with rapid treatment timelines maintained for patients with 
      CLTI.
CI  - Copyright (c) 2023 The Author(s). Published by Elsevier Inc. All rights reserved.
FAU - Messeder, Sarah Jane
AU  - Messeder SJ
AD  - Department of Cardiovascular Sciences, University of Leicester, Leicester, UK; 
      Leicester Vascular Institute, University Hospitals of Leicester NHS Trust, 
      Leicester, UK. Electronic address: sjm104@leicester.ac.uk.
FAU - Black, Imelda
AU  - Black I
AD  - NIHR Biomedical Research Unit, University Hospitals of Leicester NHS Trust, 
      Leicester, UK.
FAU - Nickinson, Andrew T O
AU  - Nickinson ATO
AD  - Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.
FAU - Houghton, John S M
AU  - Houghton JSM
AD  - Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.
FAU - Perks, Jemma
AU  - Perks J
AD  - Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.
FAU - Meffen, Anna
AU  - Meffen A
AD  - Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.
FAU - Musto, Liam
AU  - Musto L
AD  - Department of Cardiovascular Sciences, University of Leicester, Leicester, UK; 
      Leicester Vascular Institute, University Hospitals of Leicester NHS Trust, 
      Leicester, UK.
FAU - Dubkova, Svetlana
AU  - Dubkova S
AD  - Leicester Vascular Institute, University Hospitals of Leicester NHS Trust, 
      Leicester, UK.
FAU - Sayers, Robert D
AU  - Sayers RD
AD  - Department of Cardiovascular Sciences, University of Leicester, Leicester, UK; 
      Leicester Vascular Institute, University Hospitals of Leicester NHS Trust, 
      Leicester, UK.
FAU - Davies, Robert S M
AU  - Davies RSM
AD  - Department of Cardiovascular Sciences, University of Leicester, Leicester, UK; 
      Leicester Vascular Institute, University Hospitals of Leicester NHS Trust, 
      Leicester, UK.
LA  - eng
PT  - Journal Article
DEP - 20230405
PL  - Netherlands
TA  - Ann Vasc Surg
JT  - Annals of vascular surgery
JID - 8703941
SB  - IM
MH  - Humans
MH  - Male
MH  - Aged
MH  - Female
MH  - Pandemics
MH  - Risk Factors
MH  - *Endovascular Procedures/adverse effects
MH  - *Coronavirus
MH  - Ischemia
MH  - Treatment Outcome
MH  - Limb Salvage
MH  - *COVID-19
MH  - *Peripheral Arterial Disease/diagnosis/epidemiology/surgery
MH  - Chronic Limb-Threatening Ischemia
MH  - *Coronavirus Infections
MH  - Retrospective Studies
MH  - Chronic Disease
PMC - PMC10072978
EDAT- 2023/04/07 06:00
MHDA- 2023/06/19 13:08
PMCR- 2023/04/05
CRDT- 2023/04/06 19:25
PHST- 2022/12/28 00:00 [received]
PHST- 2023/03/20 00:00 [revised]
PHST- 2023/03/20 00:00 [accepted]
PHST- 2023/06/19 13:08 [medline]
PHST- 2023/04/07 06:00 [pubmed]
PHST- 2023/04/06 19:25 [entrez]
PHST- 2023/04/05 00:00 [pmc-release]
AID - S0890-5096(23)00190-5 [pii]
AID - 10.1016/j.avsg.2023.03.032 [doi]
PST - ppublish
SO  - Ann Vasc Surg. 2023 Jul;93:157-165. doi: 10.1016/j.avsg.2023.03.032. Epub 2023 
      Apr 5.