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

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.

• Authors: Raffaello Bellosta, Gabriele Piffaretti, Stefano Bonardelli, Patrizio Castelli, Roberto Chiesa, Dalmazio Frigerio, Gaetano Lanza, Stefano Pirrelli, Giovanni Rossi, Santi Trimarchi, Lombardy Covid-19 Vascular Study Group
• Journal: European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery (Eur J Vasc Endovasc Surg) Vol. 61 Issue 4 Pg. 688-697 (04 2021) ISSN: 1532-2165 [Electronic] England
• PMID: 33722483 (Publication Type: Journal Article, Multicenter Study, Observational Study)
• Copyright: Copyright © 2021 European Society for Vascular Surgery. Published by Elsevier B.V. All rights reserved.

Topics

• Aged
• Aged, 80 and over
• COVID-19
• Cohort Studies
• Female
• Health Care Surveys
• Humans
• Italy
• Male
• Middle Aged
• Postoperative Complications (epidemiology)
• Retrospective Studies
• Treatment Outcome
• Vascular Surgical Procedures