BACKGROUND: The aim of this paper was to analyze differences in clinical presentation, management, and short-term outcomes between vascular patients in two consecutive COVID-19 “waves” (i.e., first wave [W1], second wave [W2]) and the corresponding sub-population of COVID-19 positive (C19pos) patients. METHODS: Data from regional Lombardy (Italy) multicenter registry during W1 (March 8, 2020-May 3, 2020) and W2 (October 3, 2020-January 21, 2021) were collected. The primary outcome was 30-day mortality for the entire cohort. Secondary outcomes were 30-day postoperative complication and major amputation rates. Propensity score matching was used to compare waves populations. RESULTS: Data on 1276 patients (W1: N.=659; W2: N.=617) were collected, of which 121 (18.4%) and 50 (8.1%) patients were C19pos in W1 and W2, respectively (P<0.001). Considering the matched entire cohort, elective treatments increased during W2 (11.2% vs. 54.0%, P<0.001). Thirty-day mortality was lower in W2 (12% vs. 5.8%, P=0.001), 30-day postoperative complication rate improved (19.1% vs. 12.0%, P=0.003), and major amputation rates decreased (10.9% vs. 1.1%, P<0.001). Considering the matched C19pos cohorts, thirty-day mortality was similar in both waves (34.9% vs. 32.0%, P=0.786), 30-day moderate postoperative complications reduced in W2 (22.9% vs. 4.0%, P=0.033), and major amputation rates were similar. CONCLUSIONS: Although 30-day outcomes improved during W2 for the entire cohort, C19pos patients experienced similar 30-day mortality and major amputation rates comparing the two waves. Analyzing the pandemic’s impact and continued surveillance seems paramount to improve the outcomes of vascular patients.
A propensity score matching analysis comparing vascular patients in two different COVID-19 waves / Bissacco, D.; Bellosta, R.; Domanin, M.; Primo, R.; Mandigers, T. J.; Savarè, L.; Ieva, F.; Piffaretti, G.; Trimarchi, S.; Briolini, F.; Cefali, P.; Caronno, R.; Arzini, A.; Diaco, D.; Baratta, V.; Aiello, S.; Rossi, G.; Molinari, A. C.; Pirrelli, S.; Giovannini, F.; Socrate, A. M.; Ferraris, M.; Silvestro, A.; Canu, G.; Costantini, E.; Logaldo, D.; Romani, F.; Lista, A.; D'Alessio, I.; Frigerio, D.; Busoni, C.; Setti, M.; Mezzetti, R.; Sala, P.; Bassi, L.; Casana, R.; Luzzani, L.; Pegorer, M. A.; Attisani, L.; Carugati, C.; Vescovi, M.; Trabattoni, P.; Zoli, S.; Rignano, A.; Magri, C.; Vandone, P.; Losa, S.; Civilini, E.; Nano, G.; Mazzaccaro, D.; Tolva, V.; Lanza, G.; Lanza, J.; Curci, R.; Simonetti, G.; Lomazzi, C.; Grassi, V.; de Kort, J.; Chiesa, R.; Kahlberg, A.; Mascia, D.; Dallatana, R.; Carmo, M.; Ragni, F.; Marone, E. M.; Bozzani, A.; Castelli, P.; Tozzi, M.; Franchin, M.; Bonardelli, S.; Lussardi, G.; Segramora, V.; Deleo, G.; Crippa, M.; Porretta, T.; Viani, M.; Stegher, S.; For-Esti, D.. - In: ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY. - ISSN 1824-4777. - 31:1(2024), pp. 19-26. [10.23736/S1824-4777.23.01647-9]
A propensity score matching analysis comparing vascular patients in two different COVID-19 waves
Chiesa R.;Kahlberg A.;
2024-01-01
Abstract
BACKGROUND: The aim of this paper was to analyze differences in clinical presentation, management, and short-term outcomes between vascular patients in two consecutive COVID-19 “waves” (i.e., first wave [W1], second wave [W2]) and the corresponding sub-population of COVID-19 positive (C19pos) patients. METHODS: Data from regional Lombardy (Italy) multicenter registry during W1 (March 8, 2020-May 3, 2020) and W2 (October 3, 2020-January 21, 2021) were collected. The primary outcome was 30-day mortality for the entire cohort. Secondary outcomes were 30-day postoperative complication and major amputation rates. Propensity score matching was used to compare waves populations. RESULTS: Data on 1276 patients (W1: N.=659; W2: N.=617) were collected, of which 121 (18.4%) and 50 (8.1%) patients were C19pos in W1 and W2, respectively (P<0.001). Considering the matched entire cohort, elective treatments increased during W2 (11.2% vs. 54.0%, P<0.001). Thirty-day mortality was lower in W2 (12% vs. 5.8%, P=0.001), 30-day postoperative complication rate improved (19.1% vs. 12.0%, P=0.003), and major amputation rates decreased (10.9% vs. 1.1%, P<0.001). Considering the matched C19pos cohorts, thirty-day mortality was similar in both waves (34.9% vs. 32.0%, P=0.786), 30-day moderate postoperative complications reduced in W2 (22.9% vs. 4.0%, P=0.033), and major amputation rates were similar. CONCLUSIONS: Although 30-day outcomes improved during W2 for the entire cohort, C19pos patients experienced similar 30-day mortality and major amputation rates comparing the two waves. Analyzing the pandemic’s impact and continued surveillance seems paramount to improve the outcomes of vascular patients.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
