In:
Annals of Surgery, Ovid Technologies (Wolters Kluwer Health), Vol. 273, No. 4 ( 2021-04), p. 630-635
Kurzfassung:
The aim of the COVER Study is to identify global outcomes and decision making for vascular procedures during the pandemic. Background Data: During its initial peak, there were many reports of delays to vital surgery and the release of several guidelines advising later thresholds for vascular surgical intervention for key conditions. Methods: An international multi-center observational study of outcomes after open and endovascular interventions. Results: In an analysis of 1103 vascular intervention (57 centers in 19 countries), 71.6% were elective or scheduled procedures. Mean age was 67 ± 14 years (75.6% male). Suspected or confirmed COVID-19 infection was documented in 4.0%. Overall, in-hospital mortality was 11.0% [aortic interventions mortality 15.2% (23/151), amputations 12.1% (28/232), carotid interventions 10.7% (11/103), lower limb revascularisations 9.8% (51/521)]. Chronic obstructive pulmonary disease [odds ratio (OR) 2.02, 95% confidence interval (CI) 1.30–3.15] and active lower respiratory tract infection due to any cause (OR 24.94, 95% CI 12.57–241.70) ware associated with mortality, whereas elective or scheduled cases were lower risk (OR 0.4, 95% CI 0.22–0.73 and 0.60, 95% CI 0.45–0.98, respectively. After adjustment, antiplatelet (OR 0.503, 95% CI: 0.273–0.928) and oral anticoagulation (OR 0.411, 95% CI: 0.205–0.824) were linked to reduced risk of in-hospital mortality. Conclusions: Mortality after vascular interventions during this period was unexpectedly high. Suspected or confirmed COVID-19 cases were uncommon. Therefore an alternative cause, for example, recommendations for delayed surgery, should be considered. The vascular community must anticipate longer term implications for survival.
Materialart:
Online-Ressource
ISSN:
0003-4932
,
1528-1140
DOI:
10.1097/SLA.0000000000004722
Sprache:
Englisch
Verlag:
Ovid Technologies (Wolters Kluwer Health)
Publikationsdatum:
2021
ZDB Id:
2641023-0
ZDB Id:
2002200-1
