<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1646-706X</journal-id>
<journal-title><![CDATA[Angiologia e Cirurgia Vascular]]></journal-title>
<abbrev-journal-title><![CDATA[Angiol Cir Vasc]]></abbrev-journal-title>
<issn>1646-706X</issn>
<publisher>
<publisher-name><![CDATA[Sociedade Portuguesa de Angiologia e Cirurgia Vascular]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1646-706X2021000100013</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[The Vascular Surgery Emergency Department in times of COVID-19 pandemic.]]></article-title>
<article-title xml:lang="pt"><![CDATA[O Serviço de Urgência de Cirurgia Vascular em tempos de pandemia COVID-19.]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rocha]]></surname>
<given-names><![CDATA[Henrique]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Silva]]></surname>
<given-names><![CDATA[Ivone]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Antunes]]></surname>
<given-names><![CDATA[Inês]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Veiga]]></surname>
<given-names><![CDATA[Carlos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Mendes]]></surname>
<given-names><![CDATA[Daniel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Veterano]]></surname>
<given-names><![CDATA[Carlos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Castro]]></surname>
<given-names><![CDATA[João]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pinelo]]></surname>
<given-names><![CDATA[Andreia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Machado]]></surname>
<given-names><![CDATA[Rui]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Almeida]]></surname>
<given-names><![CDATA[Rui]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Centro Hospitalar Universitário do Porto Serviço de Angiologia e Cirurgia Vascular ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>03</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>03</month>
<year>2021</year>
</pub-date>
<volume>17</volume>
<numero>1</numero>
<fpage>13</fpage>
<lpage>19</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S1646-706X2021000100013&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S1646-706X2021000100013&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S1646-706X2021000100013&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Background:  The surge of the COVID-19 pandemic in Portugal and the implemented public health measures were accompanied with a noticeable decrease in patients&#8217; attendance to the Emergency Department (ED).  Objectives:  This study aims to evaluate the impact of COVID-19 pandemic on Vascular Surgery ED admissions, by comparing clinical and demographic characteristics of patients visiting the ED during the pandemic and the homologous period of 2019.  Methods:  We retrospectively collected data from patients admitted to the ED of a Portuguese tertiary hospital centre between March 4th and April 1st, 2020 - two weeks before and two weeks after the governmental implementation of the state of emergency in our country due to the COVID-19 pandemic - and the homologous period of 2019. Individual medical records were revised to obtain patients demographics and characteristics, clinical severity under the Manchester Triage System (MTS), final diagnosis, need for hospitalization or emergent/urgent surgery, in-hospital length of stay and mortality within 30 days of hospital discharge.  Results:  A total of 119 and 210 patients visited the Vascular Surgery ED during the pandemic and the homologous period of 2019, respectively. Males comprised the majority of patients in both years and the proportion of women visiting the ED was lower in 2020 compared to 2019 (P=0.015). The MTS attributed a lower number of high-priority levels (yellow and orange) to patients visiting the ED in 2020 (P=0.048). A higher proportion of patients required in-hospital treatment or emergent/urgent surgery (P&lt;0.001 and P=0.002, respectively) during the pandemic. No differences were observed in in-hospital length of stay and early mortality. The most prevalent diagnosis during this critical period were chronic limb threatening ischemia (CLTI), deep vein thrombosis, and acute limb ischemia; in 2019, CLTI, non-vascular limb pain and post-operative pain were the dominating diagnosis.  Conclusion:  We found a 43.3% decrease in the number of visits to the Vascular Surgery ED in the first month after the inaugural diagnosis of COVID-19 in Portugal. There was a significant reduction of patients with high-priority complaints, but those who presented to the ED had more severe and advanced disease, reflected by the increased proportion on hospitalization and emergent/urgent surgery requirements. Fear of infection and mobility limitations imposed by the quarantine may deter patients from attending the ED and delay proper healthcare. Mid to long-term impact of such behaviour on morbimortality should be determined to evaluate the quality of response of healthcare services to the pandemic.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução:  O crescimento da pandemia COVID-19 em Portugal e as medidas de saúde pública implementadas fizeram-se acompanhar de um acentuado decréscimo no número de pacientes admitidos no Serviço de Urgência (SU).  Objetivos:  Este estudo tem como objetivo avaliar o impacto da pandemia COVID-19 nas admissões do SU de Cirurgia Vascular, comparando as características clínicas e demográficas dos utentes que recorreram ao SU durante o período da pandemia e o período homólogo de 2019.  Métodos:  Recolhemos retrospetivamente a informação dos pacientes admitidos no SU de Cirurgia Vascular do Centro Hospitalar Universitário do Porto entre os dias 4 de Março e 1 de Abril de 2020 - duas semanas antes e duas semanas depois da implementação do estado de emergência no nosso país devido à pandemia COVID-19 - e durante o período homólogo de 2019. Foram analisados os registos clínicos para obter as características e demografia, a severidade clínica orientada pelo Sistema de Triagem de Manchester (STM), o diagnóstico final no SU, a necessidade de internamento hospitalar ou de cirurgia emergente/urgente, a duração do internamento e a mortalidade dentro de 30 dias após a alta clínica.  Resultados:  Durante o período da pandemia e o período homólogo de 2019, recorreram ao SU de Cirurgia Vascular um total de 119 e 210 utentes, respetivamente. Em ambos os anos predominaram utentes do sexo masculino, tendo-se verificado uma redução significativa na proporção de mulheres admitidas no ano de 2020 (P=0,015). Durante este período, foram triadas gravidades urgentes e muito urgentes em proporções significativamente inferiores (P=0,048). Contudo, a necessidade de internamento e de cirurgia emergente/urgente foi proporcionalmente e significativamente superior durante a pandemia (P&lt;0,001 e P=0,002, respetivamente). Não se verificaram diferenças entre o tempo de internamento e a mortalidade precoce. Os diagnósticos mais prevalentes durante este período crítico foram a isquemia crónica ameaçadora de membro (CLTI), trombose venosa profunda e a isquemia aguda de membro; em 2019 predominaram os diagnósticos de CLTI, dor no membro de etiologia não-vascular e dor pós-operatória.  Conclusão:  Identificámos uma redução de 43,3 % no número de visitas ao SU de Cirurgia Vascular no primeiro mês após o caso inaugural de COVID-19 no nosso país. Houve uma diminuição significativa dos casos urgentes e muito urgentes triados no SU, mas aqueles que recorreram a estes serviços apresentaram-se com doença mais grave e avançada, traduzido pelo aumento significativo na necessidade de cuidados em internamento e de cirurgia emergente/urgente. O medo de infeção e as limitações à mobilidade impostas pela quarentena podem dissuadir os doentes de recorrer ao SU e atrasar o tratamento médico adequado. Os efeitos a médio e longo prazo deste comportamento na morbimortalidade dos doentes deve ser determinada de forma a avaliar a qualidade da resposta dos serviços de saúde à pandemia.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Cirurgia vascular]]></kwd>
<kwd lng="pt"><![CDATA[Serviço de urgência]]></kwd>
<kwd lng="pt"><![CDATA[COVID-19]]></kwd>
<kwd lng="pt"><![CDATA[Pandemia]]></kwd>
<kwd lng="en"><![CDATA[Vascular surgery]]></kwd>
<kwd lng="en"><![CDATA[Emergency department]]></kwd>
<kwd lng="en"><![CDATA[COVID-19]]></kwd>
<kwd lng="en"><![CDATA[Pandemic]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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