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Trends and Changes in Endoscopic Management and Clinical Outcomes of Colonic Diverticular Bleeding during the

Takumi Komatsu1,2, Yoshinori Sato1, Kenichiro Tanabe3

  • 1Department of Gastroenterology, St. Marianna University School of Medicine, Kawasaki, Japan.

Journal of the Anus, Rectum and Colon
|October 30, 2024
PubMed

Insights

Endoscopic management for colonic diverticular bleeding (CDB) saw fewer early and after-hours colonoscopies during the COVID-19 pandemic. This change did not increase risks of rebleeding or adverse outcomes in CDB patients.

Area of Science:

  • Gastroenterology
  • Endoscopy
  • Public Health

Background:

  • Colonic diverticular bleeding (CDB) is a significant cause of lower gastrointestinal bleeding.
  • The COVID-19 pandemic presented challenges to healthcare delivery, potentially impacting endoscopic procedures.
  • Evaluating the impact of the pandemic on CDB management is crucial for patient care.

Purpose of the Study:

  • To assess changes in endoscopic management of CDB during the COVID-19 pandemic.
  • To compare clinical outcomes of CDB patients before and during the pandemic.
  • To determine if pandemic-related changes in endoscopy affected patient outcomes.

Main Methods:

  • A retrospective study comparing patients with CDB before (April 2017-March 2020) and during (April 2020-March 2023) the pandemic.
  • Utilized propensity score matching (PSM) for a robust comparison of 264 patients.
  • Analyzed data on colonoscopy timing, performance hours, rebleeding rates, and composite outcomes.

Main Results:

  • Fewer early colonoscopies and after-hours procedures were performed during the pandemic compared to before.
  • Despite changes in endoscopic practice, the rates of 30-day rebleeding were not significantly increased.
  • The composite outcome for CDB patients also showed no significant difference between the two periods.

Conclusions:

  • The COVID-19 pandemic led to a reduction in early and after-hours colonoscopies for colonic diverticular bleeding.
  • These modifications in endoscopic management did not adversely affect key clinical outcomes such as rebleeding or composite outcomes.
  • Findings suggest that adaptations in endoscopic practice during the pandemic were safe for patients with CDB.
Abstract

Keywords:
colonic diverticular bleedingcolonoscopycoronavirus disease-2019emergencypandemic

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