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Effects of the COVID-19 Pandemic on Colectomy Outcomes for Inflammatory Bowel Disease
Satyam K Ghodasara1, Justin S Roskam1, Michael Uretsky1
1From the Department of Surgery, Morristown Medical Center, Morristown, New Jersey.
Insights
Surgical outcomes for inflammatory bowel disease (IBD) patients undergoing colectomy showed varied results during the COVID-19 pandemic. While Crohn's disease patients experienced similar or improved outcomes, ulcerative colitis patients had a slight increase in repeat operations, yet overall management remained effective.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Epidemiology
Background:
- Inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), significantly impacts patient quality of life.
- Effective management of IBD is crucial, yet the COVID-19 pandemic presented unprecedented challenges to healthcare systems.
- The pandemic necessitated an evaluation of its impact on surgical outcomes for IBD patients.
Purpose of the Study:
- To investigate the effects of the COVID-19 pandemic on surgical outcomes for patients undergoing colectomy for IBD.
- To compare colectomy outcomes in 2020 (during the pandemic) with 2019 (pre-pandemic).
Main Methods:
- Utilized deidentified data from the American College of Surgeons National Surgical Quality Improvement Program database.
- Analyzed clinical factors and surgical outcomes for patients with CD and UC who underwent colectomy between 2019 and 2020.
Main Results:
- Patients with IBD were more likely to experience significant weight loss (>10%) before surgery in 2020.
- Colectomy operations for UC patients were shorter in 2020, and CD patients had fewer postoperative urinary tract infections or sepsis.
- Both CD and UC patients were less likely to undergo emergency operations in 2020 compared to 2019, but UC patients had an increased rate of repeat operations.
Conclusions:
- Colectomy outcomes for Crohn's disease patients in 2020 were comparable or improved versus 2019.
- Ulcerative colitis colectomies showed a statistically, though not clinically, significant rise in repeat operations in 2020.
- Despite pandemic-related healthcare system strain, IBD patients undergoing colectomy generally received effective management.
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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