1. Outcomes Following Vascular and Endovascular Procedures Performed During the First COVID-19 Pandemic Wave
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Panagiota Birmpili, Ruth A. Benson, Brenig Gwilym, Sandip Nandhra, Nina Al-Saadi, Graeme K. Ambler, Robert Blair, David Bosanquet, Nikesh Dattani, Louise Hitchman, Katherine Hurndall, Matthew Machin, Sarah Onida, Athanasios Saratzis, Joseph Shalhoub, Lauren Shelmerdine, Aminder A. Singh, Lauren, Shelmerdine, Aminder Anthony Singh, David C. Bosanquet, Rachael O. Forsythe, George Dovell, Ryan Preece, Chris Imray, Sonia Kandola, Adam Johnson, Andrew Choong, Jun Jie Ng, Sarah Aitken, Jana-Lee Moss, Efthymios Beropoulis, Konstantinos Stavroulakis, Fabrico Santiago, Amr Abdelhaliem, Aseel Abuduruk, Thomas M. Aherne, Hazem Ahmed, Sarah J. Aitken, Tasleem Akhtar, Bekir B. Akkaya, Julien Al Shakarchi, Abdeljawad J. Algasi, Musaad AlHamzah, Ahmed A. Alhumiad, Bernard Allard, Meshal Almeshal, Faris Alomran, Reem N. AlRakaf, Mohamed Altabal, Nishath Altaf, Abdulmajeed H. Altoijry, Talal Altuwaijri, Nasser Alwehaibi, Sara J. Anderson Baker, Domenico Angiletta, Afroditi Antoniou, George A. Antoniou, Libnah L. Areias, James Ashcroft, Noel Atkinson, Doaa Attia, Lukas Attwell, Mohammed A. Azab, Omar Aziz, Ahmed Y. Azzam, Christos Bakoyiannis, Hashem Barakat, Khalid Bashar, Ruth Battersby, K.S. Benaragama, Ahmed T.S. BenGhatnsh, Nikolaos Bessias, Resya Bhakthavalsalan, Shagran Binkhamis, Roshan Bootun, Emily Boyle, Ion Buga, Martin Catterson, Jennifer L. Chambers, Karishma Chandarana, Alexandros Charalabopoulos, Gabriella Charlton, Stephen W.K. Cheng, Natasha Chinai, Asad J. Choudhry, Annie Clothier, Tina U. Cohnert, Chloe Coleman, Michael Costanza, Patrick A. Coughlin, James Coulston, James Cragg, Katy Darvall, Emma M. Davies, Huw Davies, Claire Dawkins, Joseph A. Dawson, Anastasia Dean, Bedanta S. Dhal, Andrew Duncan, Mark Edwards, Bridget Egan, Mehdi El Amrani, Ahmed Elhadi, Muhammed Elhadi, Mohamed S. Eljareh, Ramy Elkady, Mohamed Elkawafi, Fatimah S. Elkhafeefi, Maysoon Elkwahad, Ibrahim A. Ellojli, Kareem ElSanhoury, Hazem Elsantawy, Khaled Elsayed, Raed M. Ennab, Owain Fisher, Robert Fitridge, Ronald L.G. Flumignan, Amy L. Fowler, Richard F. Galloway, John Gan, Andrew Garnham, Sotirios Georgopoulos, Tamer M.H. Ghatwary Tantawy, Ravi R. Goel, Mingzheng A. Goh, Tabitha Grainger, Nalaka Gunawansa, Eric Hammond, Joseph Hanna, Simon C. Hardy, Thomas J. Hardy, Gareth J. Harrison, Ahmed Hassanin, Andrew T. Hattam, Martin Hein, Hytham K.S. Hmaid, Kay Hon, Kaisor Iqbal, Hakkı Z. Iscan, Arda Isik, Doireann P. Joyce, Maciej Juszczak, Kiriaki Kakavia, Stavros Kakkos, Christos D. Karkos, Emmanuel Katsogridakis, Rana Khalil, Andrew I. Khallaf, Aazeb Khan, Manar Khashram, Samantha Khoo, Joseph Kilby, Beatrice Kuang, Ioanna Kyrou, Pierfrancesco Lapolla, Kai W. Leong, Eunice Lim, Ju-wei N. Liu, Dafydd Locker, Xun Luo, Oliver T.A. Lyons, Ragai R. Makar, Dimitris Maras, Emmeline A. Martin, Hayrettin L. Mavioglu, Dennis Mazingi, James McCaslin, David N. McClure, Kevin McKevitt, Lewis Meecham, Shreya Mehta, Fabrizio Minelli, Andrea Mingoli, Afroditi M. Mitka, Farag S. Mohamed, Hayley M. Moore, Rachael L. Morley, Konstantinos G. Moulakakis, Eustratia Mpaili, Ahmed Msherghi, Kamel Muhammad, Juanita Muller, Korana Musicki, Luis C.U. Nakano, Craig Nesbitt, Jonathan Nicholls, Andrew Nickinson, Thamer Nouh, Jose M.S. Nunag, Isaac K. Nyamekye, Michael J. Papanikolas, Theofanis T. Papas, Konstantinos O. Papazoglou, Sharath Paravastu, Noala Parr, Ketino Pasenidou, Fernando Picazo Pineda, Franklin Pond, Matthew A. Popplewell, Katarzyna Powezka, Daniela Prce, Sivaram Premnath, Raffaele Pulli, Hussein M.M. Rabee, Habibur P. Rahman, Nandhini Ravintharan, Andrés Reyes Valdivia, Toby Richards, Konstantinos Roditis, Alexander E.S. Rolls, Iain N. Roy, Hani Saeed, Prakash Saha, Alberto Saltiel, Paolo Sapienza, Emma Scott, Christopher N. Selvaraj, Atif Sharif, Simona Sica, Justinas Silickas, Gurkirat Singh, Ashwin Sivaharan, Yogeesan Sivakumaran, Pranav Somaiya, Gerry Stansby, Bethany M. Stavert, Abhilash Sudarsanam, Elizabeth Suthers, Helen Suttenwood, Ahmed Taha, Mohamed A.H. Taha, Siu C. Tam, Alethea M. Tang, Robert Tang, Dana Taran, Lawrence Tarusan, Myat S. Thet, Jacqueline Thomas, Sean Tierney, Konstantinos Tigkiropoulos, Giovanni Tinelli, Mahmoud M.H. Tolba, Hannah C. Travers, Ioannis Tsagkos, Yamume Tshomba, Paraskevi Tsiantoula, Christopher P. Twine, Berkay Ulker, Serap Ulusoy, Ertekin U. Unal, Vincent C. Varley, Thodur M. Vasudevan, Uyen G. Vo, Timothy Wagner, Stewart R. Walsh, Judy Wang, Jackie Wong, Sarah A. Warren, Chun L.P. Yih, Sergio Zacà, Adeel S. Zafar, Shady Zaki, and Ewa M. Zywicka
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Vascular surgery ,COVID-19 ,Coronavirus ,Mortality ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 ,Surgery ,RD1-811 - Abstract
Objective: The first COVID-19 pandemic wave was a period of reduced surgical activity and redistribution of resources to only those with late stage or critical presentations. This Vascular and Endovascular Research Network COVID-19 Vascular Service (COVER) study aimed to describe the six-month outcomes of patients who underwent open surgery and or endovascular interventions for major vascular conditions during this period. Methods: In this international, multicentre, prospective, observational study, centres recruited consecutive patients undergoing vascular procedures over a 12-week period. The study opened in March 2020 and closed to recruitment in August 2020. Patient demographics, procedure details, and post-operative outcomes were collected on a secure online database. The reported outcomes at 30 days and six months were post-operative complications, re-interventions, and all cause in-hospital mortality rate. Multivariable logistic regression was used to assess factors associated with six-month mortality rate. Results: Data were collected on 3 150 vascular procedures, including 1 380 lower limb revascularisations, 609 amputations, 403 aortic, 289 carotid, and 469 other vascular interventions. The median age was 68 years (interquartile range 59, 76), 73.5% were men, and 1.7% had confirmed COVID-19 disease. The cumulative all cause in-hospital, 30-day, and six-month mortality rates were 9.1%, 10.4%, and 12.8%, respectively. The six-month mortality rate was 32.1% (95% CI 24.2–40.8%) in patients with confirmed COVID-19 compared with 12.0% (95% CI 10.8–13.2%) in those without. After adjustment, confirmed COVID-19 was associated with a three times higher odds of six-month death (adjusted OR 3.25, 95% CI 2.18–4.83). Increasing ASA grade (3–5 vs. 1–2), frailty scores 4–9, diabetes mellitus, and urgent and or immediate procedures were also independently associated with increased odds of death by six months, while statin use had a protective effect. Conclusion: During the first wave of the pandemic, the six-month mortality rate after vascular and endovascular procedures was higher compared with historic pre-pandemic studies and associated with COVID-19 disease.
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- 2024
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