Mickael Palmier, Côme Bosse, Petroula Nana, Thomas Le Houérou, Mark Tyrrell, Julien Guihaire, Dominique Fabre, Stéphan Haulon
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The pandemic did not reduce the cAA ER volume (p=0.12), but a statistically significant reduction in OSR case load was recorded (p=0.04). Following OSR, hospital length of stay (11.1 vs 10.3 days), and early mortality (6.94% vs 4.63%), were similar before and during the pandemic. In the ER cohort, baseline characteristics, early mortality (3.6% vs 4.1%, p=0.976), and morbidity (10% vs 14%, p=0.44), were comparable during the 2 periods. For ER cases, the hospital and intensive care unit (ICU) stay both decreased significantly (8±8-6±7 days, p<0.001 and 2±4 vs 1±6 days p=0.01, respectively) during the pandemic.</p><p><strong>Conclusion: </strong>Resource pressures drove modifications in clinical practice to reduce the length of hospitalization, without compromising the clinical outcomes, in patients undergoing ER of cAA. This modification was not effective in patients undergoing OSR that resulted in a significant decrease of this activity.Clinical ImpactThe pandemic did not reduce complex endovascular repair (ER) volume (p=0.12) while a significant reduction in open surgical repair (OSR) case load was recorded (p=0.04). For the endovascular cohort, early mortality (p=0.976) and morbidity (p=0.44) remained stable, while the hospital and intensive care unit (ICU) stay decreased (p<0.001 and p=0.01, respectively) during the pandemic.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"1253-1258"},"PeriodicalIF":1.5000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of the COVID-19 Pandemic on Complex Aortic Aneurysm Surgery.\",\"authors\":\"Mickael Palmier, Côme Bosse, Petroula Nana, Thomas Le Houérou, Mark Tyrrell, Julien Guihaire, Dominique Fabre, Stéphan Haulon\",\"doi\":\"10.1177/15266028231210214\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>This study aimed to evaluate the impact of COVID on total case load and peri-operative outcomes in patients undergoing open surgical repair (OSR) and endovascular repair (ER) of complex aortic aneurysms (cAAs).</p><p><strong>Methods: </strong>A single-center retrospective analysis of prospective data of patients managed with elective cAA ER or OSR from January 2018 to December 2021 was conducted. A comparative analysis on the impact of the COVID-19 pandemic on the case volume and on the 30-day outcomes was assessed using time periods, before (2018-2019) and during the pandemic (2020-2021).</p><p><strong>Results: </strong>During the 4-year study period, 255 patients with cAA were managed with ER and 576 with OSR. The pandemic did not reduce the cAA ER volume (p=0.12), but a statistically significant reduction in OSR case load was recorded (p=0.04). Following OSR, hospital length of stay (11.1 vs 10.3 days), and early mortality (6.94% vs 4.63%), were similar before and during the pandemic. In the ER cohort, baseline characteristics, early mortality (3.6% vs 4.1%, p=0.976), and morbidity (10% vs 14%, p=0.44), were comparable during the 2 periods. 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引用次数: 0
摘要
前言:本研究旨在评估COVID对复杂主动脉瘤(cAAs)开放手术修复(OSR)和血管内修复(ER)患者总病例量和围手术期结局的影响。方法:对2018年1月至2021年12月择期cAA ER或OSR患者的前瞻性数据进行单中心回顾性分析。利用疫情前(2018-2019年)和疫情期间(2020-2021年)的时间段，对COVID-19大流行对病例量和30天结果的影响进行了比较分析。结果:在4年的研究期间，255例cAA患者接受ER治疗，576例接受OSR治疗。大流行没有减少cAA ER量(p=0.12)，但记录到OSR病例量有统计学意义的显著减少(p=0.04)。在OSR之后，住院时间(11.1天对10.3天)和早期死亡率(6.94%对4.63%)在大流行之前和期间相似。在ER队列中，基线特征、早期死亡率(3.6% vs 4.1%， p=0.976)和发病率(10% vs 14%， p=0.44)在两个时期具有可比性。对于急诊患者，住院时间和重症监护病房(ICU)住院时间均显著缩短(8±8-6±7天)。结论:资源压力促使临床实践改进，在不影响临床结果的情况下，减少急诊患者的住院时间。这种修饰在接受OSR的患者中无效，导致这种活性显著降低。临床影响:大流行没有减少复杂血管内修复(ER)体积(p=0.12)，但记录了开放式手术修复(OSR)病例负荷的显著减少(p=0.04)。对于血管内队列，早期死亡率(p=0.976)和发病率(p=0.44)保持稳定，而住院和重症监护病房(ICU)住院时间减少(p=0.976)
Impact of the COVID-19 Pandemic on Complex Aortic Aneurysm Surgery.
Introduction: This study aimed to evaluate the impact of COVID on total case load and peri-operative outcomes in patients undergoing open surgical repair (OSR) and endovascular repair (ER) of complex aortic aneurysms (cAAs).
Methods: A single-center retrospective analysis of prospective data of patients managed with elective cAA ER or OSR from January 2018 to December 2021 was conducted. A comparative analysis on the impact of the COVID-19 pandemic on the case volume and on the 30-day outcomes was assessed using time periods, before (2018-2019) and during the pandemic (2020-2021).
Results: During the 4-year study period, 255 patients with cAA were managed with ER and 576 with OSR. The pandemic did not reduce the cAA ER volume (p=0.12), but a statistically significant reduction in OSR case load was recorded (p=0.04). Following OSR, hospital length of stay (11.1 vs 10.3 days), and early mortality (6.94% vs 4.63%), were similar before and during the pandemic. In the ER cohort, baseline characteristics, early mortality (3.6% vs 4.1%, p=0.976), and morbidity (10% vs 14%, p=0.44), were comparable during the 2 periods. For ER cases, the hospital and intensive care unit (ICU) stay both decreased significantly (8±8-6±7 days, p<0.001 and 2±4 vs 1±6 days p=0.01, respectively) during the pandemic.
Conclusion: Resource pressures drove modifications in clinical practice to reduce the length of hospitalization, without compromising the clinical outcomes, in patients undergoing ER of cAA. This modification was not effective in patients undergoing OSR that resulted in a significant decrease of this activity.Clinical ImpactThe pandemic did not reduce complex endovascular repair (ER) volume (p=0.12) while a significant reduction in open surgical repair (OSR) case load was recorded (p=0.04). For the endovascular cohort, early mortality (p=0.976) and morbidity (p=0.44) remained stable, while the hospital and intensive care unit (ICU) stay decreased (p<0.001 and p=0.01, respectively) during the pandemic.
期刊介绍：
The Journal of Endovascular Therapy (formerly the Journal of Endovascular Surgery) was established in 1994 as a forum for all physicians, scientists, and allied healthcare professionals who are engaged or interested in peripheral endovascular techniques and technology. An official publication of the International Society of Endovascular Specialists (ISEVS), the Journal of Endovascular Therapy publishes peer-reviewed articles of interest to clinicians and researchers in the field of peripheral endovascular interventions.
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