Abstract：
BACKGROUND: During the COVID-19 pandemic, there was a dramatic increase in healthcare demand. Resources were redirected to care patients with COVID-19. Therefore, surgical treatments were affected, including those of vascular diseases. There are no studies evaluating the whole impact of the COVID-19 pandemic, considering all types of vascular procedures, both elective and urgent, in a large country. The aim of the present study was to analyze the impact on all types of vascular procedures performed in Brazilian public hospitals during the COVID-19 pandemic.
METHODS: Cross-sectional population-based analysis of publicly available data referring to vascular procedures. Surgeries 2 years before the pandemic onset (2018-2019) and 2 years during pandemic (2020-2021) were included.
RESULTS: We observed a total of 521,069 procedures. Decrease was observed in elective abdominal aortic aneurysm repairs both open surgery (P = 0.001) and endovascular surgery (P < 0.001), emergency open abdominal repairs (P = 0.005), elective thoracic aortic aneurysm repairs (P = 0.007), elective open peripheral aneurysm repairs (P = 0.038), carotid endarterectomies (P < 0.001) and angioplasties (P = 0.001), open revascularizations for peripheral arterial disease (P < 0.001), surgical treatment of chronic venous disease (P < 0.001) and sympathectomies for hyperhidrosis (P < 0.001). However, there was an increase of lower limb amputations (P = 0.027) and vena cava filter placements (P = 0.005). There was a reduction of almost US$17 million in financial investments.
CONCLUSIONS: The reorganization of health systems led to a significant reduction in vascular procedures and decrease in financial investments. On the other hand, there was a significant increase in the number of lower limb amputations and vena cava filter placements.
METHODS: Cross-sectional population-based analysis of publicly available data referring to vascular procedures. Surgeries 2 years before the pandemic onset (2018-2019) and 2 years during pandemic (2020-2021) were included.
RESULTS: We observed a total of 521,069 procedures. Decrease was observed in elective abdominal aortic aneurysm repairs both open surgery (P = 0.001) and endovascular surgery (P < 0.001), emergency open abdominal repairs (P = 0.005), elective thoracic aortic aneurysm repairs (P = 0.007), elective open peripheral aneurysm repairs (P = 0.038), carotid endarterectomies (P < 0.001) and angioplasties (P = 0.001), open revascularizations for peripheral arterial disease (P < 0.001), surgical treatment of chronic venous disease (P < 0.001) and sympathectomies for hyperhidrosis (P < 0.001). However, there was an increase of lower limb amputations (P = 0.027) and vena cava filter placements (P = 0.005). There was a reduction of almost US$17 million in financial investments.
CONCLUSIONS: The reorganization of health systems led to a significant reduction in vascular procedures and decrease in financial investments. On the other hand, there was a significant increase in the number of lower limb amputations and vena cava filter placements.
摘要：
背景：在COVID-19大流行期间，医疗保健需求急剧增加。资源被重定向到COVID-19的护理患者。因此,手术治疗受到影响，包括血管疾病。没有研究评估COVID-19大流行的整体影响，考虑到所有类型的血管手术，选修和紧急，在一个大国。本研究的目的是分析COVID-19大流行期间对巴西公立医院进行的所有类型血管手术的影响。
方法：对涉及血管手术的公开数据进行基于人群的横断面分析。包括大流行发作前两年（2018年至2019年）和大流行期间两年（2020年至2021年）的手术。
结果：我们共观察到521,069例手术。在选择性腹主动脉瘤修复术中观察到开放手术（p=0.001）和血管内手术（p<0.001）的减少，紧急开放式腹部AAA修复（p=0.005），选择性胸主动脉瘤修复术(p=0.007)，选择性开放周围动脉瘤修复术(p=0.038)，颈动脉内膜切除术（p<0.001）和血管成形术（p=0.001），周围动脉疾病的开放血运重建(p<0.001)，慢性静脉疾病的手术治疗（p<0.001）和多汗症的交感神经切除术（p<0.001）。然而,下肢截肢(p=0.027)和腔静脉滤器位置(p=0.005)增加.金融投资减少了近1700万美元。
结论：卫生系统的重组导致血管手术的显著减少和金融投资的减少。另一方面,下肢截肢和腔静脉滤器放置次数显著增加.
方法：对涉及血管手术的公开数据进行基于人群的横断面分析。包括大流行发作前两年（2018年至2019年）和大流行期间两年（2020年至2021年）的手术。
结果：我们共观察到521,069例手术。在选择性腹主动脉瘤修复术中观察到开放手术（p=0.001）和血管内手术（p<0.001）的减少，紧急开放式腹部AAA修复（p=0.005），选择性胸主动脉瘤修复术(p=0.007)，选择性开放周围动脉瘤修复术(p=0.038)，颈动脉内膜切除术（p<0.001）和血管成形术（p=0.001），周围动脉疾病的开放血运重建(p<0.001)，慢性静脉疾病的手术治疗（p<0.001）和多汗症的交感神经切除术（p<0.001）。然而,下肢截肢(p=0.027)和腔静脉滤器位置(p=0.005)增加.金融投资减少了近1700万美元。
结论：卫生系统的重组导致血管手术的显著减少和金融投资的减少。另一方面,下肢截肢和腔静脉滤器放置次数显著增加.
