Purpose
Our study goal was to investigate interventional radiology case volume trends during the COVID-19 pandemic at our large academic hospital compared to the affiliated imaging centers.
Materials and Methods
Our study was a descriptive retrospective study of interventional radiology (IR) imaging studies performed at our large urban academic hospital, affiliated outpatient center, and affiliated community center from January 5, 2020, to August 15, 2020. Imaging volume assessment was separated into prestate of emergency (SOE) period (before SOE in Massachusetts, (January 5, 2020, through March 7, 2020), “post-SOE” period (time after “nonessential” services closure, March 22, 2020, through May 16, 2020), “transition” period (between pre-SOE and post-SOE), and recovery period (time after Massachusetts permits resumption of non-emergency procedures or deferred cases, May 17, 2020, to August 15, 2020). Data was presented as mean with 95% confidence interval (CI). Statistical analysis was performed using Prism (GraphPad, San Diego, CA).
Results
IR imaging volume began to decrease on March 11, 2020, with a large decrease in imaging volume from 5,908 studies performed between weeks 1 to 9 to 1,927 between weeks 12 to 19. The average weekly volume decreased by 63% from weeks 1-9 (656 studies) to weeks 12-19 (241 studies; P < 0.0001). By site, during the pandemic, the weekly volume at the main hospital campus declined from 496 studies (weeks 1-9; 100% baseline) to 167 studies (weeks 12-19; 34% of baseline). At the affiliated outpatient center, weekly volume went from 38 studies (weeks 1-9; 100% baseline) to 43 studies (weeks 12-19; 113% of baseline). During the recovery, the main hospital campus has returned to 407 cases, 82% of baseline, P = 0.002, community cases are back to baseline of 123, 101% of baseline, P = 0.93, and outpatient weekly cases have increased to 49 (129% of baseline, P < 0.001). At the main campus, 75% of the difference in baseline was in fluoroscopy, the majority of which consists of 4 procedures, a 58% drop in fluoroscopic interventional oncology (TACE, Y90, selective internal radiation therapy planning), a 14% drop in AV fistula maintenance procedures, a 30% drop in suprapubic tubes maintenance and exchanges, and a 27% drop in port revisions and removals.
Conclusions
COVID-19 induced a steep decline in case volume in the hospital with an increase in outpatient cases. During the recovery, case volume has nearly recovered to pre-pandemic levels with a persistent increase in outpatient cases. The asymmetric drop in hospital-based cases compared to outpatient may be secondary to fears around COVID-19.
| Multivariate Analysis on the Effect of Bleeding Disorder on Postoperative Outcomes Following Lower Extremity Endovascular Interventions for Peripheral Arterial Disease | ||||
|---|---|---|---|---|
| Outcome | Odds Ratio | Lower Confidence Limit | Upper Confidence Limit | P Value |
| Mortality | 1.8 | 1.27 | 2.53 | 0.001 |
| Any complication | 1.29 | 1.04 | 2.87 | < 0.0001 |
| Pulmonary complication | 1.36 | 0.98 | 1.85 | 0.067 |
| Renal failure | 2.55 | 1.48 | 4.38 | 0.0001 |
| Cardiac complication | 1.5 | 1.01 | 2.07 | 0.014 |
| CNS complication | 2.17 | 0.99 | 4.42 | 0.06 |
| Sepsis | 1.28 | 0.93 | 1.75 | 0.13 |
| UTI | 2.57 | 1.46 | 4.54 | 0.0013 |
| VTE | 1.18 | 0.57 | 2.5 | 0.69 |
| Readmission | 1.02 | 0.89 | 1.17 | 0.75 |
| Reoperation | 1.15 | 0.99 | 1.34 | 0.68 |
| Wound complication | 0.94 | 0.69 | 1.28 | 0.75 |
| Whole blood or pRBC transfusion | 1.96 | 1.67 | 2.29 | < 0.0001 |