Modeling the Elective Vascular Surgery Recovery After COVID-19: Implications for Moving Forward

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Journal of vascular surgery


OBJECTIVE: Delays in elective surgery caused by the COVID-19 pandemic have resulted in a substantial backlog of cases. In the current study, we sought to determine the estimated time to recovery for vascular surgery procedures delayed due to COVID-19 in a regional health system.

METHODS: Utilizing data from a 35-hospital regional vascular surgical collaborative consisting of all hospitals performing vascular surgery in the state of Michigan, a 35-hospital regional health collaborative consisting of all hospitals completing vascular surgery procedures within the state of Michigan, we estimated delayed surgical cases for adults undergoing carotid endarterectomy, carotid stenting, endovascular and open abdominal aortic aneurysm repair, and lower extremity bypass. We utilized Seasonal Autoregressive Integrated Moving Average (ARIMA) models to predict surgical volume in the absence of the COVID-19 pandemic and utilized historical data to predict elective surgical recovery time.

RESULTS: Median statewide monthly vascular surgical volume for the study period was 439 procedures, with a maximum statewide monthly case volume of 519 procedures. For the month of April 2020, elective vascular surgery procedural volume decreased by approximately 90%. Significant variability was seen in estimated hospital capacity as well as estimated backlogged cases, with the recovery of elective cases estimated to take approximately 8 months. If hospitals across the collaborative share the burden of backlogged cases, the recovery could be shortened to approximately 3 months.

CONCLUSION: In this study of vascular surgical volume in a regional health collaborative, elective surgical procedures decreased by 90% resulting in a backlog of over 700 cases. Recovery time if all hospitals in the collaborative share the burden of backlogged cases would be reduced from 8 months to 3 months, underscoring the necessity of regional and statewide policies to minimize patient harm due to delays in recovery for elective surgery.

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ePub ahead of print