Clinical Report: Impact of Surgical Delay on Outcomes in IBD Patients
Overview
This multicenter cohort study evaluated the effects of surgical delays on postoperative outcomes in patients with inflammatory bowel disease (IBD) during the COVID-19 pandemic. Despite a 23.9% reduction in surgical procedures, no significant difference was found in the median time to surgery or 30-day postoperative complications between pandemic and pre-pandemic cohorts.
Background
Patients with IBD often require surgical intervention within ten years of diagnosis due to inadequate symptom control or disease complications. The COVID-19 pandemic led to postponement of elective surgeries, raising concerns about disease progression and increased surgical complexity. Limited data exist on the clinical consequences of delaying IBD-related surgeries, prompting this study to assess the impact of surgical postponement on postoperative outcomes.
Data Highlights
Parameter
Pre-COVID-19 Cohort
COVID-19 Cohort
p-value
Number of Surgical Procedures
46
35
Not reported
Median Time from Indication to Surgery (days)
33.5 (IQR 7.3–66.8)
34 (IQR 7–66.5)
0.867
Percentage of Laparoscopic Procedures
Not specified
54.3%
Not reported
30-day Major Postoperative Complications
Not specified
Not specified
No significant difference
Key Findings
The number of surgical IBD procedures decreased by 23.9% during the COVID-19 pandemic compared to the previous year.
The median interval between surgical indication and procedure was similar between cohorts (approximately 34 days), indicating no significant surgical delay during the pandemic.
No significant differences were observed in baseline patient characteristics, including age, disease type, and ASA classification, between cohorts.
The majority of surgeries were performed laparoscopically (54.3%).
There was no significant increase in 30-day postoperative complications or severity of complications during the pandemic period.
Clinical Implications
These findings suggest that despite the COVID-19 pandemic and associated healthcare disruptions, timely surgical care for IBD patients was largely maintained without increasing postoperative risks. Clinicians can be reassured that short-term delays within the observed timeframe may not adversely affect surgical outcomes. Continued monitoring and prioritization of surgical scheduling remain important to prevent disease progression.
Conclusion
In this multicenter cohort study, surgical delays for IBD patients during the COVID-19 pandemic did not significantly impact the timing of surgery or postoperative complication rates. Maintaining timely surgical intervention is feasible and critical for optimal patient outcomes.
References
Study Authors/Multicenter Cohort Analysis/2022 -- Effects of Surgical Delay on Postoperative Results in Patients with Inflammatory Bowel Disease
by Ellen de Bock, Eline S. Herman, Vincent Meij, Thijs A. Burghgraef, Bas Oldenburg, Paul M. Verheijen, Apollo Pronk, Mando D. Filipe, Menno R. Vriens, Milan C. Richir
