{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,4,2]],"date-time":"2022-04-02T11:48:36Z","timestamp":1648900116480},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"11-12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,12,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>In response to the Coronavirus 2019 (COVID-19) pandemic, vascular surgeons in the Veteran Affairs Health Care System have been undertaking only essential cases, such as advanced critical limb ischemia. Surgical risk assessment in these patients is often complex, considers all factors known to impact short- and long-term outcomes, and the additional risk that COVID-19 infection could convey in this patient population is unknown. The European Centre for Disease Prevention and Control (ECDC) published risk factors (ECDC-RF) implicated in increased COVID-19 hospitalization and case-fatality which have been further evidenced by initial reports from the United States Centers for Disease Control and Prevention. CDC reports additionally indicate that African American (AA) patients have incurred disparate infection outcomes in the United States. We set forth to survey the Veterans Affairs Surgical Quality Improvement Program (VASQIP) database over a nearly 20\u00a0year span to inform ongoing risk assessment with an estimation of the prevalence of ECDC-RF in our veteran critical limb ischemia population and investigate whether an increased COVID-19 comorbidity burden exists for AA veterans presenting for major non-traumatic amputation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>The VASQIP database was queried for all above knee amputation (AKA) and below knee amputation (BKA) completed 1999\u20132018 after IRB approval (MIRB:#02507). Patient race and ECDC-RF including male gender, age\u00a0&amp;gt;\u00a060\u00a0years, smoking status, hypertension, diabetes, chronic obstructive pulmonary disease, cancer, and cardiovascular disease were recorded from preoperative patient history. AKA and BKA cohorts were compared via \u03c72-test with Yates correction or unpaired t-test and a subgroup analysis was conducted between AA and all other race patients for COVID-19 comorbidities in each cohort.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>VASQIP query returned 50,083 total entries. Average age was 65.1\u00a0\u00b1\u00a010.4\u00a0years and 68.2\u00a0\u00b1\u00a010.5\u00a0years for BKA and AKA cohorts, respectively, (P\u00a0&amp;lt;\u00a0.0001) and nearly all patients were male (99%). At least one ECDC-RF comorbidity was present in 25,526 (88.7%) of BKA and 17,558 (82.4%) of AKA patients (P\u00a0&amp;lt;\u00a0.0001). AA BKA patients were significantly more likely than non-AA BKA patients to present with at least one ECDC-RF comorbidity (P\u00a0=\u00a0.01).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>According to a large national Veterans Affairs database, there are high rates of ECDC-RF in veteran amputees. During the present crisis, management of these patients should incorporate telehealth, expedient discharge, and ongoing COVID-19 transmission precautions.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usaa180","type":"journal-article","created":{"date-parts":[[2020,6,30]],"date-time":"2020-06-30T07:44:03Z","timestamp":1593503043000},"page":"e2124-e2130","source":"Crossref","is-referenced-by-count":0,"title":["Optimizing Peripandemic Care for Veteran Major Non-Traumatic Lower Extremity Amputees: A Proposal Informed by a National Retrospective Descriptive Analysis of COVID-19 Risk Factor Prevalence"],"prefix":"10.1093","volume":"185","author":[{"given":"James M","family":"Dittman","sequence":"first","affiliation":[{"name":"Department of Surgery, Virginia Commonwealth University School of Medicine, Richmond, VA 23298"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wayne","family":"Tse","sequence":"additional","affiliation":[{"name":"Department of Surgery, Central Virginia Veterans Affairs Health Care System, Richmond, VA 23249"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael F","family":"Amendola","sequence":"additional","affiliation":[{"name":"Department of Surgery, Central Virginia Veterans Affairs Health Care System, Richmond, VA 23249"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,12,30]]},"reference":[{"issue":"3","key":"2020123002500123100_ref1","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1016\/j.apmr.2007.11.005","article-title":"Estimating the prevalence of limb loss in the United States: 2005 to 2050","volume":"89","author":"Ziegler-Graham","year":"2008","journal-title":"Arch Phys Med Rehabil"},{"issue":"1","key":"2020123002500123100_ref2","doi-asserted-by":"crossref","first-page":"50","DOI":"10.2337\/dc18-1380","article-title":"Resurgence of diabetes-related nontraumatic lower-extremity amputation in the young and 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