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Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
Postoperative outcomes of surgical delay in inflammatory bowel disease patients: a multicenter cohort study
Ellen de Bock1, Eline S Herman2, Vincent Meij2
1Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands. E.deBock-3@umcutrecht.nl.
Insights
Surgical delays for inflammatory bowel disease (IBD) patients did not increase during the COVID-19 pandemic. However, longer intervals between surgical indication and procedure correlated with higher postoperative complication risks.
Area of Science:
- Gastroenterology and Surgery
- Epidemiology
- Healthcare Management
Background:
- Postponement of surgical care for inflammatory bowel disease (IBD) can exacerbate disease progression.
- The COVID-19 pandemic presented challenges to timely medical interventions, including elective surgeries.
Purpose of the Study:
- To evaluate the impact of delayed surgical procedures in IBD patients during the COVID-19 pandemic on clinical outcomes.
- To identify risk factors associated with postoperative complications in IBD patients.
Main Methods:
- A multicenter retrospective cohort study comparing IBD patients who underwent surgery during the COVID-19 pandemic (March 16, 2020 - December 31, 2020) with a pre-pandemic cohort.
- Primary endpoint: incidence of major postoperative complications. Secondary endpoints: time from surgical indication to procedure, and risk factors for complications via multivariate analysis.
Main Results:
- No significant difference in the median time interval between surgical indication and procedure was observed between the pandemic and pre-pandemic cohorts (34 vs. 33.5 days).
- Multivariate analysis indicated that a longer interval between surgical indication and procedure was significantly associated with an increased risk of postoperative complications (OR 1.03, p=0.034).
- Previous surgery emerged as an independent predictor for major postoperative complications (OR 4.25, p=0.018).
Conclusions:
- While the COVID-19 pandemic did not cause significant surgical delays for IBD patients, extended intervals between indication and surgery increase complication risks.
- Maintaining surgical procedures for IBD patients is crucial, especially during periods of healthcare resource scarcity, to prevent disease progression and adverse outcomes.
Abstract:
Postponement of surgical inflammatory bowel disease (IBD) care may lead to disease progression. This study aims to determine the influence of delayed surgical IBD procedures on clinical outcomes. This multicenter retrospective cohort study included IBD patients who underwent a surgical procedure during the Coronavirus disease 2019 (COVID-19) pandemic from March 16, 2020, to December 31, 2020, and were compared to a pre-COVID-19 cohort. The primary endpoint was determining the number of (major) postoperative complications. Secondary endpoints were the time interval between surgical indication and performance of the surgical procedure and the risk factors of postoperative complications using multivariate analysis. Eighty-one IBD patients who underwent a surgical procedure were included. The median time interval between surgical indication and performance of the surgical procedure did not differ between the COVID-19 and pre-COVID-19 cohorts (34 vs. 33.5 days, p = 0.867). Multivariate analysis revealed a longer time interval between surgical indication and surgical procedure significantly correlated with the risk of developing postoperative complications [odds ratio (OR) 1.03, p = 0.034]. Moreover, previous surgery was identified as an independent predictor (OR 4.25, p = 0.018) for an increased risk of developing major postoperative complications. There was no significant surgical delay for patients with IBD in the COVID-19 pandemic cohort compared to the pre-pandemic cohort. However, a longer time interval between surgical indication and surgical procedure significantly correlated with the risk of developing postoperative complications. In the event of future scarcity in healthcare, efforts should be made to continue surgical procedures in IBD patients.
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