Impact of the COVID-19 lock down strategy on vascular surgery practice: more major amputations than usual

Schuivens, Puck M.E.; Buijs, Manon; Boonman-de Winter, Leandra; Veen, Eelco J.; de Groot, Hans F.W.; Buimer, Thijs G.; Ho, Gwan H.; van der Laan, Lijckle

OBJECTIVES: To investigate the impact of the COVID-19 lockdown period on the number and type of vascular procedures performed in the operating theatre. METHODS: 38 patients that 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 that underwent respectively 36 and 66 vascular procedures in the same time period. Data was analysed with SPSS statistics. RESULTS: Our study shows that the lockdown during the COVID-19 pandemic resulted in a significant increase in number of major amputations (42% in 2020 vs 18% and 15% in 2019 and 2020 respectively; p-value .019). Furthermore, we observed a statistically significant difference in the degree of tissue loss as categorized by the Rutherford classification (p-value .007). During the lockdown period patients presented with more extensive ischemic damage when compared to previous years. We observed no difference in vascular surgical care for patients with an aortic aneurysm. CONCLUSION: 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 policymakers should be aware of the impact of their measurements on vulnerable patient groups like patients with peripheral arterial occlusive disease. For these patients medical care should be easily accessible and adequate.