Related Experiment Video
Updated: Nov 28, 2025
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Vascular surgery triage during the coronavirus disease 2019 pandemic
Mark R Sarfati1, Claire L Griffin1, Larry W Kraiss1
1Division of Vascular Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah.
Insights
The American College of Surgeons (ACS) COVID-19 guidelines effectively triaged vascular surgery patients, reducing surgical volumes without increasing morbidity during the pandemic. Incorporating SURGCON/VASCCON could further enhance these triage strategies.
Area of Science:
- Vascular Surgery
- Surgical Triage
- Pandemic Response
Background:
- The COVID-19 pandemic led to increased hospitalizations and scarcity of medical resources.
- This necessitated the development of strategies for triaging surgical patients.
- Vascular surgery faced unique challenges due to the nature of its procedures and patient populations.
Purpose of the Study:
- To describe the experience of using American College of Surgeons (ACS) COVID-19 guidelines for triaging vascular surgery patients.
- To evaluate the effectiveness of these guidelines in managing surgical volumes during the pandemic.
- To assess patient outcomes and adverse events related to delayed treatment.
Main Methods:
- Retrospective analysis of vascular surgery triage during the initial month of COVID-19 restrictions.
- Utilized ACS guidelines to categorize and prioritize surgeries.
- Reviewed operating room schedules and electronic medical records (EMRs) for performed and postponed surgeries.
- Assigned ACS category, condition, and tier class to all cases.
- Identified and reviewed adverse events in postponed cases.
Main Results:
- 69 surgeries were performed on 52 patients, all for emergent, urgent, or time-sensitive elective diagnoses.
- The majority of performed surgeries were tier 3 (68%) and tier 2b (32%).
- Surgery was postponed for 66 patients, predominantly from tier 1 (55%) and tier 2a (33%).
- Only 3 (4.5%) of postponed patients experienced adverse events linked to treatment delay.
Conclusions:
- The ACS triage guidelines proved effective in reducing vascular surgical volumes during the COVID-19 pandemic.
- The implemented triage strategy did not lead to an increase in patient morbidity.
- Enhancing the guidelines with the SURGCON/VASCCON threat level alert system could improve clinical utility.
Objective:
The coronavirus disease 2019 (COVID-19) pandemic has resulted in a marked increase in hospital usage, medical resource scarcity, and rationing of surgical procedures. This has created the need for strategies to triage surgical patients. We have described our experience using the American College of Surgeons (ACS) COVID-19 guidelines for triage of vascular surgery patients in an academic surgery practice.
Methods:
We used the ACS guidelines as a framework to direct the triage of vascular surgery patients during the COVID-19 pandemic. We retrospectively analyzed the results of this triage during the first month of surgical restriction at our hospital. Patients undergoing surgery were identified by reviewing the operating room schedule. We reviewed the electronic medical records (EMRs) and assigned an ACS category, condition, and tier class to each completed surgery. Surgeries that were postponed during the same period were identified from a prospectively maintained list. We reviewed the EMRs for all postponed surgeries and assigned an ACS category, condition, and tier class to each surgery. We reviewed the EMRs for all postponed procedures to identify any adverse events related to the treatment delay.
Results:
We performed 69 surgeries in 52 patients during the study period. All surgeries were performed to treat emergent, urgent, or time-sensitive elective diagnoses. Of the 69 surgeries, 47 (68%) were from tier 3 and 22 (32%) from tier 2b. We did not perform any surgeries from tier 1 or 2a. We postponed surgery for 66 patients during the same period, of which 36 (55%) were from tier 1, 22 (33%) from tier 2a, 5 (8%) from tier 2b, and 3 (5%) could not be assigned a tier class. No tier 3 surgeries were postponed. Of the 66 patients, 3 (4.5%) experienced an adverse event that could be attributed to the treatment delay.
Conclusions:
The ACS triage guidelines provided an effective method to decrease vascular surgical volumes during the COVID-19 pandemic without an increase in patient morbidity. We believe the clinical utility of the guidelines would be strengthened by incorporating the SURGCON/VASCCON (surgical activity condition/vascular activity condition) threat level alert system.
More Related Videos
09:36Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device
Published on: September 24, 2020
09:03Nasal Brushing Sampling and Processing Using Digital High Speed Ciliary Videomicroscopy – Adaptation for the COVID-19 Pandemic
Published on: November 7, 2020
Related Concept Videos
01:22Aneurysm IV: Nursing Management
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
01:23Peripheral Artery Disease V: Postoperative Nursing Management
01:28Esophageal Varices-II: Clinical Features and Management
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
01:28Acute Coronary Syndrome IV: Interprofessional Care