Abstract
Objectives: To analyze the outcome of vascular procedures performed in patients with COVID-19 infection during the 2020 pandemic.
Methods: This is a multicenter, prospective observational cohort study. We analyzed data from 75 patients with COVID-19 infection undergoing vascular surgery procedures in 17 hospitals across Spain and Andorra between March and May 2020. The primary end point was 30-day mortality. Clinical Trials registry number NCT04333693 .
Results: The mean age was 70.9 (45-94) and 58 (77.0%) patients were male. Around 70.7% had postoperative complications, 36.0% of patients experienced respiratory failure, 22.7% acute renal failure, and 22.7% acute respiratory distress syndrome (ARDS). All-cause 30-days mortality rate was 37.3%. Multivariate analysis identified age >65 years (P = 0.009), American Society of Anesthesiologists (ASA) classification IV (P = 0.004), preoperative lymphocyte count <0.6 (×10 9 /L) (P = 0.001) and lactate dehydrogenase (LDH) >500 (UI/L) (P = 0.004), need for invasive ventilation (P = 0.043), postoperative acute renal failure (P = 0.001), ARDS (P = 0.003) and major amputation (P = 0.009) as independent variables associated with mortality. Preoperative coma (P = 0.001), quick Sepsis Related Organ Failure Assessment (qSOFA) score ≥2 (P = 0.043), lymphocytes <0.6 (×10 9 /L) (P = 0.019) leucocytes >11.5 (×10 9 /L) (P = 0.007) and serum ferritin >1800 mg/dL (P = 0.004), bilateral lung infiltrates on thorax computed tomography (P = 0.025), and postoperative acute renal failure (P = 0.009) increased the risk of postoperative ARDS. qSOFA score ≥2 was the only risk factor associated with postoperative sepsis (P = 0.041).
Conclusions: Patients with COVID-19 infection undergoing vascular surgery procedures showed poor 30-days survival. Age >65 years, preoperative lymphocytes <0.6 (x10 9 /L) and LDH >500 (UI/L), and postoperative acute renal failure, ARDS and need for major amputation were identified as prognostic factors of 30-days mortality.
【초록키워드】 ARDS, pandemic, Respiratory failure, Mortality, hospital, Infection, LDH, Sepsis, outcome, risk factor, lactate dehydrogenase, invasive ventilation, Computed tomography, Lymphocyte count, lymphocyte, survival, clinical, male, Patient, Spain, complications, age, mortality rate, multicenter, assessment, acute respiratory distress, Multivariate analysis, 30-Day mortality, acute renal failure, leucocyte, Prognostic factor, qSOFA, Thorax, Society, Serum ferritin, Vascular, independent variable, failure, syndrome, primary end point, Coma, preoperative, analyzed, performed, postoperative, bilateral lung infiltrate, increased the risk, patients with COVID-19, prospective observational cohort, with COVID-19, 【제목키워드】 surgery, procedure, with COVID-19,