ONE YEAR OUTCOMES OF PATIENTS SURGICALLY TREATED FOR ACUTE LOWER LIMB ISCHEMIA BEFORE AND DURING THE COVID-19 PANDEMIC – A RETROSPECTIVE COHORT STUDY IN A CHILEAN VASCULAR CENTER emil.karonen@med.lu.se

353-06

ONE YEAR OUTCOMES OF PATIENTS SURGICALLY TREATED FOR ACUTE LOWER LIMB ISCHEMIA BEFORE AND DURING THE COVID-19 PANDEMIC – A RETROSPECTIVE COHORT STUDY IN A CHILEAN VASCULAR CENTER

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Sweden

Oral or Poster

Acute lower limb ischemia (ALI) is a limb and life-threatening surgical emergency. The Coronavirus disease-19 (Covid-19) pandemic caused a significant strain on health care systems worldwide, resulting in high morbidity and mortality. This study aims to compare major outcomes in patients undergoing surgical treatment for ALI before and during the Covid-19 pandemic.

Retrospective cohort study of patients (n=112) undergoing surgical treatment for ALI between January 1st, 2016, and May 5th, 2023, at a university hospital in Santiago, Chile. January 30th, 2020, marked the start of the Covid-19 pandemic group (n=53). Univariable logistic regression analysis was performed for 30-days and one-year mortality, major amputation, combined major amputation/mortality, with further multivariable analysis, adjusting for open vascular surgery. Fisher’s exact test was used for subgroup analysis of patients treated during the pandemic before, compared to after, the introduction of vaccination program.

The major amputation rate at 30-days and one-year was 3.5% and 6.3% in the pre-pandemic group compared to 17.3% and 24.5% in the pandemic group. The odds of one-year major amputation were significantly higher for the pandemic group in univariable OR: 4.87 (95% CI: 1.27-18.54), but not in multivariable OR: 3.52 (95% CI: 0.88-14.05), analysis. During the Covid-19 pandemic, initiation of the vaccination program was associated with a decrease in one-year mortality from 29.4% to 2.8% (p=0.01).

Undergoing surgical treatment during, compared to prior to, the Covid-19 pandemic was associated with increased odds of major amputation, but the association was attenuated in adjusted analysis.