Early Vascular Surgery Response to the COVID-19 Pandemic: Results of a Nationwide Survey

• Published in: Journal of vascular surgery 2021-02, Vol.73 (2), p.372-380
• Main Authors: Latz, Christopher A., MD, MPH, Boitano, Laura T., MD, MPH, Png, C. Y. Maximilian, MD, Tanious, Adam, MD, MMSc, Kibrik, Pavel, DO, Conrad, Mark, MD, MMSc, Eagleton, Matthew, MD, Dua, Anahita, MD, MS, MBA
• Format: Article
• Language: English
• Subjects: COVID-19; COVID-19 - diagnosis; COVID-19 - epidemiology; COVID-19 and vascular disease; COVID-19 and vascular surgeon; Elective Surgical Procedures - standards; Elective Surgical Procedures - statistics & numerical data; Health Care Surveys; Humans; Internet; Pandemics - statistics & numerical data; Patient Care - standards; Patient Care - statistics & numerical data; Personal Protective Equipment - statistics & numerical data; Practice Patterns, Physicians' - standards; Practice Patterns, Physicians' - statistics & numerical data; Professional Practice - standards; Professional Practice - statistics & numerical data; SARS-CoV-2; Surgery; Thoracic Surgery - standards; Thoracic Surgery - statistics & numerical data; United States - epidemiology; Vascular surgery and COVID-19; Vascular Surgical Procedures - standards; Vascular Surgical Procedures - statistics & numerical data
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1016/j.jvs.2020.05.032

ObjectivesThe COVID-19 pandemic has had major implications for the United States healthcare system. This survey study sought to identify practice changes, understand current personal protection equipment (PPE) use, and determine how caring for patients with COVID-19 differs for vascular surgeons practicing in states with high COVID-19 case numbers versus low case numbers. MethodsA fourteen-question online survey regarding the effect of the COVID-19 pandemic on vascular surgeons’ current practice was sent to 365 vascular surgeons across the country via REDCap from 4/14/2020 to 4/21/2020 with responses closed on 4/23/2020. The survey response was analyzed with descriptive statistics. Further analyses were performed to evaluate whether responses from states with the highest number of COVID-19 cases (New York, New Jersey, Massachusetts, Pennsylvania and California) differed from those with lower case numbers (all other states). ResultsA total of 121 vascular surgeon responded (30.6%) to the survey. All high-volume states were represented. The majority of vascular surgeons are reusing PPE The majority of respondents worked in an academic setting (81.5%) and were performing only urgent and emergent cases (80.5%) during preparation for the surge. This did not differ between high case and low COVID case states (p=0.285). High case states were less likely to perform a lower extremity intervention for critical limb ischemia (60.8% vs. 77.5%, p=0.046), but otherwise case types did not differ. Most attendings work with residents (90.8%) and limited their exposure to procedures on suspected/confirmed COVID-19 cases (56.0%). Thirty-eight percent of attendings have been redeployed within the hospital to a vascular access service, and/or other service outside of vascular surgery. This was more frequent in high case volume states compared to low case volume states (p=0.039). The majority of vascular surgeons are reusing PPE (71.4%) and N95 masks (86.4%), and 21% of vascular surgeons feel that they do not have adequate PPE to perform clinical their duties. ConclusionThe initial response to the COVID-19 pandemic has resulted in reduced elective cases with primarily only urgent and emergent cases being performed. A minority of vascular surgeons have been redeployed outside of their specialty, however, this is more common among states with high case numbers. Adequate PPE remains an issue for almost a quarter of vascular surgeons who responded to this survey.