The impact of the COVID-19 pandemic on a dedicated vascular emergency clinic
Messeder, Sarah Black, Imelda Musto, Liam Dubkova, Svetlana Sayers, Robert Davies, Robert
Messeder, Sarah
Black, Imelda
Musto, Liam
Dubkova, Svetlana
Sayers, Robert
Davies, Robert
Abstract
Background: Vascular Emergency Clinics (VEC) improve patient outcomes in chronic limb-threatening ischemia (CLTI). They provide a "1 stop" open access policy, whereby "suspicion of CLTI" by a healthcare professional or patient leads to a direct review. We assessed the resilience of the outpatient VEC model to the first year of the coronavirus disease (COVID-19) pandemic.
Methods: A retrospective review of a prospectively maintained database of all patients assessed in our VEC for lower limb pathologies between March 2020 and April 2021 was performed. This was cross-referenced to national and loco-regional Governmental COVID-19 data. Individuals with CLTI were further analysed to determine Peripheral Arterial Disease-Quality Improvement Framework compliance.
Results: Seven hundred and ninety one patients attended for 1,084 assessments (Male n = 484, 61%; Age 72.5 ± standard deviation 12.2 years; White British n = 645, 81.7%). In total, 322 patients were diagnosed with CLTI (40.7%). A total of 188 individuals (58.6%) underwent a first revascularization strategy (Endovascular n = 128, 39.8%; Hybrid n = 41, 12.7%; Open surgery n = 19, 5.9%; Conservative n = 134, 41.6%). Major lower limb amputation rate was 10.9% (n = 35) and mortality rate was 25.8% (n = 83) at 12 months of follow-up. Median referral to assessment time was 3 days (interquartile range: 1-5). For the nonadmitted patient with CLTI, the median assessment to intervention was 8 days (interquartile range: 6-15) and median referral to intervention time of 11 days (11-18).
Conclusions: The VEC model has demonstrated strong resilience to the COVID-19 pandemic with rapid treatment timelines maintained for patients with CLTI.
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Date
2023-04-04
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Messeder, S. J., Black, I., Nickinson, A. T. O., Houghton, J. S. M., Perks, J., Meffen, A., Musto, L., Dubkova, S., Sayers, R. D., & Davies, R. S. M. (2023). The Impact of the COVID-19 Pandemic on a Dedicated Vascular Emergency Clinic. Annals of vascular surgery, 93, 157–165. Advance online publication. https://doi.org/10.1016/j.avsg.2023.03.032