The COVID-19 pandemic has strained the resources of health care systems worldwide, impairing their ability to timely and effectively respond to the population's health needs. During some pandemic periods, the number and patients' conditions were critical, conditioning high responsibility actions in poorly trained personnel. This fact could have a paper on the number of iatrogenic events. The World Health Organization (WHO) defines iatrogenesis as the side effects and risks associated with the medical intervention. This study aimed to estimate the cumulative incidence of urgent interventions in our Vascular Surgery department (VS) due to iatrogenic events during some of the COVID pandemic waves (2020-2021) and compare it to some control periods (2018-2019).

We conducted a Unicenter retrospective study during six periods: • Two COVID-19 pandemic periods: 1) first wave: March 1-May 30, 2020: COVID 1 2) fifth wave: July 1-September 30, 2021: COVID 5 • Four control periods during the same months of the waves to reduce variability: 3) March 1-May 30, 2019, 4) July 1-September 30, 2019 5) March 1-May 30, 2018 6) and July 1-September 30, 2018 We include patients who require any urgent invasive treatment (puncture, open or endovascular surgery) performed by the VS team. We collected demographic data, vascular risk factors, diagnoses, treatments and death. We estimated the cumulative incidences and 95% confidence interval (95%CI). We performed an exploratory comparative analysis between some COVID-19 pandemic periods and correlated control periods.

We analyzed 222 patients distributed as seen in table 1: (Table 1. Total interventions) The cumulative incidence of urgent interventions due to iatrogenic events in COVID-19 pandemic periods and control periods is displayed in Table 2: (Table 2. Cumulative incidence of urgent interventions secondary to iatrogenic events in every period) The primary diagnoses of urgent interventions for iatrogenic interventions were bleeding (29.7%, 22/74) and pseudoaneurysm (31%, 23/74). For non-iatrogenic interventions, they were acute ischemia syndrome (41.2%, 61/148) and irreversible ischemia (22.9%, 33/148). Table 3 shows the mortality rate distribution according to every COVID-19 pandemic period related to controls: (Table 3. Mortality rate comparison)

We did not find differences between COVID-19 pandemic periods and control periods in the incidence of urgent interventions secondary to iatrogenic events. Likewise, we didn't observe differences in overall mortality rates. However, we found a trend toward higher mortality when urgent interventions were performed for iatrogenic events non-related to COVID-19 pandemic.

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