COVID-19 大流行期间炎症性肠病手术的趋势和结果：来自多机构研究网络的倾向得分匹配回顾性分析

IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL Health Science Reports Pub Date : 2024-09-29 DOI:10.1002/hsr2.70107

Fiona Wu, Gema H. Ibarburu, Caris Grimes

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引用次数: 0

摘要

背景和目的 2019 年冠状病毒病（COVID-19）大流行对炎症性肠病（IBD）患者的管理产生了影响。为保护医疗资源并防止 COVID-19 的传播，IBD 患者的择期手术和监测性内镜检查被推迟。本研究旨在描述大流行期间 IBD 手术的趋势和结果。方法这是一项回顾性倾向评分匹配分析，使用的数据来自多机构研究数据库 TriNetX。在 2019 年 3 月至 2020 年 2 月（大流行前）和 2020 年 3 月至 2023 年 2 月（大流行）期间，确定了接受手术的 IBD 患者。比较了大流行期间和大流行前的每月 IBD 手术量。配对后，比较了大流行期间和大流行前 3 年中 IBD 手术不良后果的风险。结果在大流行期间，IBD 的择期手术和急诊手术都有所减少。这些趋势并不明显。经过匹配后，在大流行的 3 年中，重返手术室和再次入院的风险相当。在大流行的第一年和第二年，择期手术患者的死亡风险更高（风险比 [RR]，2；95% 置信区间 [CI]，分别为 1.160-3.448 和 RR，1.778；95% CI，1.003-3.150），急诊组群的重症监护入院风险更高（RR，1.759；95% CI，1.126-2.747 和 RR，1.742；95% CI，1.131-2.682）。结论我们的研究强调了 COVID-19 大流行对接受手术的 IBD 患者管理的影响。这些结果为危机时期的 IBD 手术管理提供了启示，有助于指导需要手术治疗的 IBD 患者的决策和资源分配。

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The trends and outcomes of inflammatory bowel disease surgery during the COVID-19 pandemic: A retrospective propensity score-matched analysis from a multi-institutional research network

Background and Aims

The coronavirus disease 2019 (COVID-19) pandemic has affected the management of inflammatory bowel disease (IBD) patients. Elective operations and surveillance endoscopies were postponed for IBD patients to preserve healthcare resources and to prevent the spread of COVID-19. This study aimed to describe the trends and outcomes of IBD surgery during the pandemic.

Methods

This was a retrospective propensity score-matched analysis using data extracted from TriNetX, a multi-institutional research database. IBD patients admitted for surgery were identified between March 2019 to February 2020 (prepandemic) and March 2020 to February 2023 (pandemic). The monthly volume of IBD surgical procedures was compared during the pandemic to the prepandemic period. After matching, the risk of adverse outcomes following IBD surgery was compared between the 3 years of the pandemic compared to the prepandemic cohort.

Results

There was a reduction in both elective and emergency IBD operations during the pandemic. These trends were not significant. After matching, the risks of returning to theaters and hospital readmission were comparable across the 3 years of the pandemic. In the first and second years of the pandemic, elective patients were at a greater risk of mortality (risk ratio [RR], 2; 95% confidence interval [CI], 1.160–3.448 and RR, 1.778; 95% CI, 1.003–3.150, respectively) and the emergency cohort had a higher risk of critical care admission (RR, 1.759; 95% CI, 1.126–2.747 and RR, 1.742; 95% CI, 1.131–2.682, respectively).

Conclusion

Our study highlights the impact of the COVID-19 pandemic on the management of IBD patients undergoing surgery. These results provide insights into the management of IBD surgery during times of crisis and can help guide decision-making and resource allocation for IBD patients requiring surgical intervention.

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