Hospitalization rate and treatment strategy for critical limb ischemia in south Sardinia during COVID-19

BACKGROUND: The year 2020 was characterized by COVID-19 pandemic with a consequent profound change in health systems and difficulties in accessing care for patients suffering from chronic diseases other than COVID-19, including critical limb ischemia (CH). The main purpose of this study was to verify whether the COVID-19 pandemic has led to a reduction in the hospital admission rate to the vascular surgeries of southern Sardinia and an increase in major amputations rate in patients suffering from CLI. METHODS: In our retrospective multicenter study, data of patients were analyzed using two different time frames for comparison: the year before Italian lockdown (P1) and the first year of pandemic (P2). Primary outcome was the rate of CLI-related hospitalization in the two period. Secondary outcomes were medical treatment, revascularization, and primary amputation rates. RESULTS: A total of 137 and 140 patients were admitted for CLI in the study centers during P1 and P2 respectively, with a comparable monthly hospitalization rate in the two periods (IRR 0.98;CI: 0.77-1.25;P=0.86). The median age was 76 years in P1 and 71 years in P2 (P=0.09);the two cohorts were comparable for demographical characteristics and risk factors. Patients treated medically in PI were 14% vs. 9% in P2 (P-0.298), 64% of patients underwent urgent revascularization in P1 vs. 70% in P2 (P=0.61) and 22% underwent primary amputation in P1 vs. 19% in P2 (P=0.58). CONCLUSIONS: Our study showed no significant differences in CLI-related hospitalization and in-hospital amputation rate between P1 and P2 in Southern Sardinia.