{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T05:54:25Z","timestamp":1762322065425,"version":"3.40.5"},"reference-count":34,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T00:00:00Z","timestamp":1710374400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The COVID\u201019 pandemic led to changes in health care, including postponement of nonurgent appointments. These changes, combined with overall decreased activity levels, may have placed individuals with vascular disease at increased risk for skin ulceration and amputation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the rates of lower limb amputation in Veterans due to complications of diabetes and\/or vascular disease in the year following onset of the COVID\u201019 pandemic (March 2020\u2013March 2021) compared to the previous 3\u2009years (March 2017\u2013March 2020).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective chart review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Minneapolis Veterans Affairs Health Care System.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Veterans with a vascular consult appointment note between March 1, 2017, and February 28, 2021.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interventions<\/jats:title><jats:p>Not applicable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>Primary outcome was lower limb amputation rate in the year following onset of the COVID\u201019 pandemic compared to the previous 3\u2009years. Secondary outcome was the rate of lower limb wounds in the same time frame. We hypothesized that rates of lower limb amputation and wounds increased during the pandemic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Vascular consult appointments (<jats:italic>n<\/jats:italic>\u2009=\u20094183) were reviewed between March 1, 2017, and February 28, 2021. Significantly higher rates of amputation (7.52% vs. 5.19%; <jats:italic>p<\/jats:italic>\u2009=\u2009.006) and wound presence (16.77% vs. 11.66%; <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) were found 1\u2009year postpandemic compared to the previous 3\u2009years. Amputation and wound rates did not significantly increase between pairs of consecutive years prior to the pandemic but significantly increased between the year preceding the pandemic and the first year of the pandemic (amputation <jats:italic>p<\/jats:italic>\u2009=\u2009.047; wound <jats:italic>p<\/jats:italic>\u2009=\u2009.004).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Increased rates of amputation and wounds in Veterans following the onset of the COVID\u201019 pandemic are likely due to disruption of care, lifestyle changes, and other pandemic\u2010related factors. Awareness of COVID\u201019\u2010related negative health effects is imperative for health care providers to ensure appropriate allocation of resources and alternate models for care delivery for amputation and preventative care as part of disaster response.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pmrj.13130","type":"journal-article","created":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T07:46:26Z","timestamp":1710402386000},"page":"973-980","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Impact of the <scp>COVID<\/scp>\u201019 pandemic on the rate of lower limb amputation in Veterans"],"prefix":"10.1002","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6850-0373","authenticated-orcid":false,"given":"Kierra J.","family":"Falbo","sequence":"first","affiliation":[{"name":"Rehabilitation &amp; Engineering Center for Optimizing Veteran Engagement &amp; Reintegration (RECOVER), Minneapolis Veterans Affairs Health Care System  Minneapolis Minnesota USA"},{"name":"Department of Rehabilitation Medicine, Division of Rehabilitation Science University of Minnesota College of Medicine  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2813-9293","authenticated-orcid":false,"given":"Nicole R.","family":"Walker","sequence":"additional","affiliation":[{"name":"Rehabilitation &amp; Engineering Center for Optimizing Veteran Engagement &amp; Reintegration (RECOVER), Minneapolis Veterans Affairs Health Care System  Minneapolis Minnesota USA"},{"name":"Department of Rehabilitation Medicine, Division of Rehabilitation Science University of Minnesota College of Medicine  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amber L.","family":"Wacek","sequence":"additional","affiliation":[{"name":"Rehabilitation &amp; Engineering Center for Optimizing Veteran Engagement &amp; Reintegration (RECOVER), Minneapolis Veterans Affairs Health Care System  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"II","given":"Juan E.","family":"Cave","sequence":"additional","affiliation":[{"name":"Rehabilitation &amp; Engineering Center for Optimizing Veteran Engagement &amp; Reintegration (RECOVER), Minneapolis Veterans Affairs Health Care System  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew D.","family":"Sauerbrey","sequence":"additional","affiliation":[{"name":"Rehabilitation &amp; Engineering Center for Optimizing Veteran Engagement &amp; Reintegration (RECOVER), Minneapolis Veterans Affairs Health Care System  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy A.","family":"Gravely","sequence":"additional","affiliation":[{"name":"Rehabilitation &amp; Engineering Center for Optimizing Veteran Engagement &amp; Reintegration (RECOVER), Minneapolis Veterans Affairs Health Care System  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary E.","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Division of Rehabilitation Science University of Minnesota College of Medicine  Minneapolis Minnesota USA"},{"name":"Department of Rehabilitation &amp; Extended Care Minneapolis Veterans Affairs Health Care System  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John M.","family":"Looft","sequence":"additional","affiliation":[{"name":"Rehabilitation &amp; Engineering Center for Optimizing Veteran Engagement &amp; Reintegration (RECOVER), Minneapolis Veterans Affairs Health Care System  Minneapolis Minnesota USA"},{"name":"Department of Rehabilitation Medicine, Division of Rehabilitation Science University of Minnesota College of Medicine  Minneapolis Minnesota USA"},{"name":"Department of Prosthetics &amp; Patient Services Minneapolis Veterans Affairs Health Care System  Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,3,14]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa2001191"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591\u2010020\u20100952\u2010y"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.20.00510"},{"key":"e_1_2_6_5_1","unstructured":"COVID\u201019: Recommendations for management of elective surgical procedures.2020."},{"key":"e_1_2_6_6_1","unstructured":"Non\u2010emergent elective medical services and treatment recommendations. 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