The Vascular Surgery Emergency Department in Times of COVID-19 Pandemic

Résumé fourni par la source

Objective: The surge of the COVID-19 pandemic in Portugal and the implemented public health measures were accompanied by a noticeable decrease in patient attendances at the emergency department (ED).This study primarily aimed to describe the impact of the COVID-19 pandemic on vascular surgery ED admissions.Its secondary aims were to compare the clinical and demographic characteristics of patients visiting the ED during the pandemic with the same period in 2019.Methods: Data were collected retrospectively from patients admitted to the ED of a tertiary Portuguese hospital centre between 4 March and 1 April 2020 e two weeks before and two weeks after government implementation of a "state of emergency" in Portugal as a result of the COVID-19 pandemic.The data were compared with data from patients admitted in the same period of 2019.Individual medical records were reviewed to obtain patient demographics and characteristics, clinical severity under the Manchester Triage System (MTS), final diagnosis, need for hospitalisation or emergency/urgent surgery, length of hospital stay, and death within 30 days of hospital discharge.Results: A total of 119 patients visited the vascular surgery ED during the pandemic period e a reduction of >40% compared with the previous year.Males comprised the majority of patients in both years and the average age overlapped at around 64e65 years; the youngest and the eldest were those who most avoided visiting the ED during the pandemic.The MTS attributed a higher number of low priority levels to patients who visited the ED in 2020, yet the percentage of patients requiring both hospitalisation and emergency/urgent surgery was similar.The most prevalent diagnoses during this critical period were chronic limb threatening ischaemia (CLTI), deep vein thrombosis, and acute limb ischaemia; in 2019, CLTI, non-vascular limb pain, and post-operative pain were the dominant diagnoses.Conclusion: There was a 43.3% decrease in the number of visits to the vascular surgery ED in the first month after the first diagnosis of COVID-19 in Portugal.During the pandemic, patients presented at the ED with more severe and advanced diseases, increasing the hospitalisation and emergency/urgent surgery rates.Fear of infection and mobility limitations imposed by the quarantine may have dissuaded patients from attending the ED and delayed proper healthcare.The mid to long term impact of such behaviour on morbimortality should be determined to evaluate the quality of response of healthcare services to the pandemic.

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