Impact of COVID-19 on the Society for Vascular Surgery Vascular Quality Initiative Venous Procedure Registries (Varicose Vein and Inferior Vena Cava Filter)

Mahenthiran, Ashorne K.; Natarajan, Jay P.; Bertges, Daniel J.; Huffman, Kristopher M.; Eldrup-Jorgensen, Jens; Lemmon, Gary W.

In response to the pandemic, an abrupt pivot of VQI physician members away from standard clinical practice to a restrictive phase of emergent and urgent vascular procedures occurred. The Society for Vascular Surgery Patient Safety Organization queried both data managers and physicians in May 2020. Approximately three fourths (74%) of physicians adopted restrictive operating policies for urgent and emergent cases only, while one half proceeded with ‘time sensitive’ elective cases as urgent. Data manager case entry was negatively affected by both low case volumes and staffing due to re-assignment or furlough. Venous registry volumes were reduced five-fold in 1(st) Quarter of 2020 compared to a similar period in 2019. The consequences of delaying vascular procedures for ambulatory venous practice remain unknown with increased morbidity likely. Challenges to determine venous thromboembolism mortality impact exist given difficulty in verifying ‘in home and extended care facility’ deaths. Further ramifications of a pandemic shutdown will likely be amplified if postponement of elective vascular care extends beyond a short window of time. It will be important to monitor disease progression and case severity as a result of policy shifts adopted locally in response to pandemic surges.