Results Of Implementation Of Acs Guidelines For Covid-19 In An Academic Community Setting
Sepehr Karimi, MD.
Quinnipiac Univeristy, Oakville, CT, USA.
Objective: In 2020 a novel strain of coronavirus caused a global pandemic. The first reported case in the state of Connecticut was on March 8, 2020. We instituted the ACS guidelines on vascular surgery and applied them to Waterbury Hospital. Our objective was to minimize the risk of COVID infection, and maximize medical and surgical benefit for those in need of vascular intervention. Methods: We gathered data from March 20 - May 11, 2020 and assessed the measures taken to minimize risk of infection, risk stratification of patients based on the ACS guidelines, and the percentage of who were affected by COVID-19. We also analyzed the cases that were scheduled and subsequently cancelled due to COVID and the consequence of delaying these interventions. Results: During this 51-day period, there were 48 vascular operations performed on 28 patients. Using the ACS guidelines for COVID 19 elective case triage, 81% of the operations performed fall under the Tier 3 category - do not postpone; 17% were Tier 2b operations - postpone if possible; and the remaining 1% were Tier 2a - consider postponing. Of the patients who underwent these operations none tested positive for COVID-19 and 15 patients tested negative for COVID during their hospital stay. We noticed that during the pandemic patients were hesitant to be seen in the office which lead to progression of disease and the need for more aggressive and urgent treatment. Conclusions: The ACS guidelines were effective and safe after implementation. The clear majority of operations performed were ones that the ACS guidelines supported continuing without delay, and the remaining could not be postponed due to various patient factors. Furthermore, none of our patients tested positive for COVID-19 before, or after, their operation making the guidelines safe for our community setting.
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