Impact of COVID-19 on the Society for Vascular Surgery Vascular Quality Initiative Arterial Procedure Registry.
clinical practice shift; Covid-19; physician survey; VQI arterial registry
This manuscript describes the abrupt pivot of VQI physician members away from standard clinical practice to a restrictive phase of emergent and urgent vascular procedures in response to the pandemic. The Society for Vascular Surgery Patient Safety Organization queried both data managers and physicians in May 2020 to discern pandemic impact. Approximately three fourths (74%) of physicians adopted a restrictive operating policy for urgent and emergent cases only, yet one half considered 'time sensitive' elective cases as urgent. Data manager case entry was affected by both low case volume and staffing due to re-assignment or furlough. A seven-fold reduction in arterial VQI case volume entry was noted in 1(st) Quarter of 2020 when compared to same period in 2019. The downstream consequences of delaying vascular procedures for carotid, aortic, vascular access and chronic limb ischemia remain undetermined. Further ramifications of a pandemic shutdown will likely be amplified if resumption of elective vascular care extends beyond a short window of time.
Natarajan JP;Mahenthiran AK;Bertges DJ;Huffman KM;Eldrup-Jorgensen J;Lemmon GW
Journal Of Vascular Surgery
2021
2021-02-03
journalArticle
<a href="http://doi.org/10.1016/j.jvs.2020.12.087" target="_blank" rel="noreferrer noopener">10.1016/j.jvs.2020.12.087</a>
Impact of COVID-19 on the Society for Vascular Surgery Vascular Quality Initiative Venous Procedure Registries (Varicose Vein and Inferior Vena Cava Filter).
clinical practice shift; Covid-19; physician survey; VQI venous registry
In response to the pandemic, an abrupt pivot of VQI physician members away from standard clinical practice to a restrictive phase of emergent and urgent vascular procedures occurred. The Society for Vascular Surgery Patient Safety Organization queried both data managers and physicians in May 2020. Approximately three fourths (74%) of physicians adopted restrictive operating policies for urgent and emergent cases only, while one half proceeded with 'time sensitive' elective cases as urgent. Data manager case entry was negatively affected by both low case volumes and staffing due to re-assignment or furlough. Venous registry volumes were reduced five-fold in 1(st) Quarter of 2020 compared to a similar period in 2019. The consequences of delaying vascular procedures for ambulatory venous practice remain unknown with increased morbidity likely. Challenges to determine venous thromboembolism mortality impact exist given difficulty in verifying 'in home and extended care facility' deaths. Further ramifications of a pandemic shutdown will likely be amplified if postponement of elective vascular care extends beyond a short window of time. It will be important to monitor disease progression and case severity as a result of policy shifts adopted locally in response to pandemic surges.
Mahenthiran AK;Natarajan JP;Bertges DJ;Huffman KM;Eldrup-Jorgensen J;Lemmon GW
Journal Of Vascular Surgery. Venous And Lymphatic Disorders
2021
2021-01-19
journalArticle
<a href="http://doi.org/10.1016/j.jvsv.2021.01.002" target="_blank" rel="noreferrer noopener">10.1016/j.jvsv.2021.01.002</a>
Racial differences in performance-based function and potential explanatory factors among individuals with knee osteoarthritis.
Female; Humans; Male; Aged; Middle Aged; Socioeconomic Factors; Pain Measurement; African Americans; Body Mass Index; European Continental Ancestry Group; Exercise Test; Knee Joint/physiopathology; Osteoarthritis Knee/physiopathology; Physical Functional Performance
Objective: In individuals with knee osteoarthritis (OA), self-reported physical function is poorer in African Americans than in whites, but whether this difference holds true for objective assessments is unclear. The purpose of this study was to examine racial differences in performance-based physical function as well as potential underlying factors contributing to these racial differences.; Methods: Participants with knee OA from a randomized controlled trial completed the 2-minute step test (2MST), timed-up-and-go (TUG), and 30-second chair stand (30s-CST) at baseline. Race differences in performance-based function were assessed by logistic regression. Separate models were adjusted for sets of demographic, socioeconomic, psychological health, and physical health variables.; Results: In individuals with knee OA (n = 322; 72% women, 22% African American, mean ± SD age 66 ± 11 years, mean ± SD body mass index 31 ± 8 kg/m 2 ), African Americans (versus whites) had greater unadjusted odds of poorer function (30s-CST odds ratio [OR] 2.79 [95% confidence interval (95% CI) 1.65-4.72], 2MST OR 2.37 [95% CI 1.40-4.03], and TUG OR 3.71 [95% CI 2.16-6.36]). Relationships were maintained when adjusted for demographic and psychological health covariates, but they were either partially attenuated or nonsignificant when adjusted for physical health and socioeconomic covariates.; Conclusion: African American adults with knee OA had poorer unadjusted performance-based function than whites. Physical health and socioeconomic characteristics diminished these differences, emphasizing the fact that these factors may be important to consider in mitigating racial disparities in function. (© 2019, American College of Rheumatology.)
Flowers PPE;Schwartz TA;Arbeeva L;Golightly YM;Pathak A;Cooke J;Gupta JJ;Callahan LF;Goode AP;Corsi M;Huffman KM;Allen KD
Arthritis Care & Research
2020
2020-09
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
journalArticle
<a href="http://doi.org/10.1002/acr.24018" target="_blank" rel="noreferrer noopener">10.1002/acr.24018</a>