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Impact of the COVID-19 Lockdown Strategy on Vascular Surgery Practice: More Major Amputations than Usual
Puck M E Schuivens1, Manon Buijs1, Leandra Boonman-de Winter2
1Department of Surgery, Amphia Hospital, Breda, The Netherlands.
Insights
The COVID-19 lockdown significantly increased major amputations and tissue loss in vascular patients, highlighting the need for accessible care for those with peripheral arterial occlusive disease.
Area of Science:
- Vascular Surgery
- Public Health Policy
Background:
- The coronavirus disease 2019 (COVID-19) pandemic necessitated public health measures, including lockdowns.
- These measures may have impacted healthcare delivery for non-COVID-19 conditions.
Purpose of the Study:
- To evaluate the effect of the COVID-19 lockdown on vascular procedures.
- To assess changes in patient outcomes and disease severity.
Main Methods:
- Retrospective analysis of vascular procedures performed during the March 16-April 30, 2020 lockdown.
- Comparison with data from the same periods in 2019 and 2018.
- Statistical analysis using SPSS Statistics.
Main Results:
- A significant increase in major amputations (42% in 2020 vs. 18-15% in prior years; P=0.019).
- Greater tissue loss (Rutherford classification) observed during lockdown (P=0.007).
- No change in aortic aneurysm procedure care.
Conclusions:
- COVID-19 lockdown measures adversely affected non-COVID-19 vascular care, leading to increased severe morbidity.
- Policy makers must consider the impact on vulnerable populations like peripheral arterial occlusive disease patients.
- Ensuring accessible and adequate medical care for these patients is crucial.
Background:
The aim of this study is to investigate the impact of the coronavirus disease 2019 (COVID-19) lockdown period on the number and type of vascular procedures performed in the operating theater.
Methods:
A total of 38 patients who underwent 46 vascular procedures during the lockdown period of March 16th until April 30th, 2020, were included. The control groups consisted of 29 patients in 2019 and 54 patients in 2018 who underwent 36 and 66 vascular procedures, respectively, in the same time period. Data were analyzed using SPSS Statistics.
Results:
Our study shows that the lockdown during the COVID-19 pandemic resulted in a significant increase in the number of major amputations (42% in 2020 vs. 18% and 15% in 2019 and 2020, respectively; P-value 0.019). Furthermore, we observed a statistically significant difference in the degree of tissue loss as categorized by the Rutherford classification (P-value 0.007). During the lockdown period, patients presented with more extensive ischemic damage when than previous years. We observed no difference in vascular surgical care for patients with an aortic aneurysm.
Conclusions:
Measurements taken during the lockdown period have a significant effect on non-COVID-19 vascular patient care, which leads to an increased severe morbidity. In the future, policy makers should be aware of the impact of their measurements on vulnerable patient groups such as those with peripheral arterial occlusive disease. For these patients, medical care should be easily accessible and adequate.
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