Effects of the COVID-19 Pandemic on Colectomy Outcomes for Inflammatory Bowel Disease.

IF 1 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL Southern Medical Journal Pub Date : 2024-02-01 DOI:10.14423/SMJ.0000000000001650
Satyam K Ghodasara, Justin S Roskam, Michael Uretsky, Grace C Chang, Rolando H Rolandelli, Zoltan H Nemeth
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Abstract

Objectives: Inflammatory bowel disease (IBD) encompasses Crohn's disease (CD) and ulcerative colitis (UC). These two chronic inflammatory conditions can differ in severity, presentation, and anatomical localization, and can greatly affect quality of life if not managed properly. Given the many healthcare challenges during the coronavirus disease 2019 pandemic, we studied the effects of the pandemic and corresponding changes to medical resources on surgical outcomes for patients with IBD.

Methods: Deidentified data from patients who underwent a colectomy for CD or UC were collected from the National Surgical Quality Improvement Program database of the American College of Surgeons. We analyzed clinical factors and surgical outcomes between 2019 and 2020.

Results: Patients with IBD were more likely to have lost >10% of their body mass before the operation in 2020. Operations for patients with UC were significantly shorter in the first year of the pandemic. Patients with CD were less likely to have a urinary tract infection or sepsis postoperatively in 2020, whereas patients with UC were more likely to require a repeat operation. Interestingly, both patient populations were less likely to undergo an emergency operation in 2020 than in 2019.

Conclusions: Colectomy outcomes for patients with CD in 2020 were similar or improved in comparison with those seen in 2019, whereas colectomies for UC saw a statistically but not clinically significant increase in the rate of repeat operations. Overall, these patients seem to have been well managed despite the coronavirus disease 2019 pandemic-induced strain on the healthcare system.

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COVID-19 大流行对炎症性肠病结肠切除术结果的影响。
目的:炎症性肠病(IBD)包括克罗恩病(CD)和溃疡性结肠炎(UC)。这两种慢性炎症的严重程度、表现形式和解剖定位各不相同,如果处理不当,会严重影响生活质量。鉴于 2019 年冠状病毒疾病大流行期间医疗保健面临诸多挑战,我们研究了大流行和医疗资源的相应变化对 IBD 患者手术效果的影响:从美国外科学院的国家外科质量改进计划数据库中收集了因 CD 或 UC 而接受结肠切除术的患者的去身份数据。我们分析了2019年至2020年间的临床因素和手术结果:2020年,IBD患者在手术前体重下降>10%的可能性更大。在大流行的第一年,UC 患者的手术时间明显缩短。2020 年,慢性结肠炎患者术后发生尿路感染或败血症的可能性较小,而慢性直肠炎患者需要再次手术的可能性较大。有趣的是,与2019年相比,这两类患者在2020年接受急诊手术的可能性更低:2020年CD患者的结肠切除术结果与2019年相似或有所改善,而UC结肠切除术的重复手术率在统计学上有显著增加,但临床意义不大。总体而言,尽管2019年冠状病毒疾病大流行给医疗系统造成了压力,但这些患者似乎得到了很好的管理。
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来源期刊
Southern Medical Journal
Southern Medical Journal 医学-医学:内科
CiteScore
1.40
自引率
9.10%
发文量
222
审稿时长
4-8 weeks
期刊介绍: As the official journal of the Birmingham, Alabama-based Southern Medical Association (SMA), the Southern Medical Journal (SMJ) has for more than 100 years provided the latest clinical information in areas that affect patients'' daily lives. Now delivered to individuals exclusively online, the SMJ has a multidisciplinary focus that covers a broad range of topics relevant to physicians and other healthcare specialists in all relevant aspects of the profession, including medicine and medical specialties, surgery and surgery specialties; child and maternal health; mental health; emergency and disaster medicine; public health and environmental medicine; bioethics and medical education; and quality health care, patient safety, and best practices. Each month, articles span the spectrum of medical topics, providing timely, up-to-the-minute information for both primary care physicians and specialists. Contributors include leaders in the healthcare field from across the country and around the world. The SMJ enables physicians to provide the best possible care to patients in this age of rapidly changing modern medicine.
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