The use of, and outcomes for, inflammatory bowel disease services during the Covid‐19 pandemic: a nationwide observational study
Background Inflammatory bowel disease (IBD) services have been particularly affected by the Covid‐19 pandemic. Delays in referral to secondary care and access to investigations and surgery have been exacerbated. Aims To investigate the use of and outcomes for emergency IBD care during the Covid‐19 p...
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| Veröffentlicht in: | Alimentary pharmacology & therapeutics 2022-04, Vol.55 (7), p.836-846 |
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| creator | Deputy, Mohammed Sahnan, Kapil Worley, Guy Patel, Komal Balinskaite, Violeta Bottle, Alex Aylin, Paul Burns, Elaine M Hart, Ailsa Faiz, Omar |
| description | Background
Inflammatory bowel disease (IBD) services have been particularly affected by the Covid‐19 pandemic. Delays in referral to secondary care and access to investigations and surgery have been exacerbated.
Aims
To investigate the use of and outcomes for emergency IBD care during the Covid‐19 pandemic.
Methods
Nationwide observational study using administrative data for England (2015‐2020) comparing cohorts admitted from 1 January 2015, to 31 January 2020 (pre‐pandemic) and from 1 February 2020, to 31 January 2021 (pandemic). Autoregressive integrated moving average forecast models were run to estimate the counterfactual IBD admissions and procedures for February 2020 to January 2021.
Results
Large decreases in attendances to hospital for emergency treatment were observed for both acute ulcerative colitis (UC, 16.4%) and acute Crohn’s disease (CD, 8.7%). The prevalence of concomitant Covid‐19 during the same episode was low [391/16 494 (2.4%) and 349/15 613 (2.2%), respectively]. No significant difference in 30‐day mortality was observed. A shorter median length of stay by 1 day for acute IBD admissions was observed (P |
| doi_str_mv | 10.1111/apt.16800 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9111430</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2626892175</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4430-35d78727986613ef70fb979e0159d1800bbcc2364b5f68764c4334fbfdeaa32b3</originalsourceid><addsrcrecordid>eNp1kctq3DAUhkVoaaZpF3mBIsgmhTjRxZbtLAJh6A0C6WK6FrocJQq2NZXsGWZX-gR9xj5JNZk0NIFqI4S-8-kc_QgdUnJK8zpTy_GUioaQPTSjXFQFI1y8QDPCRFuwhvJ99DqlO0KIqAl7hfZ5RTkTgs_Qz8Ut4CkBDu4Eq8HiMI0m9JCwC_EE-8F1qu_VGOIG67CGDlufQOWCBHHlTQbtFP1wg8csmoeVt79__KItXmYZ9N6cY4UHNfowrL3Nz-ht3f1ZdTiNk928QS-d6hK8fdgP0LePHxbzz8XV9acv88urwpQlJwWvbN3UrG4bISgHVxOn27oFQqvW0jy81sYwLkpdOdHUojQl56XTzoJSnGl-gC523uWke7AGhjGqTi6j71XcyKC8fHoz-Ft5E1ayzX-cO8iC4wdBDN8nSKPsfTLQdWqAMCXJBBNNy2hdZfToGXoXpphH3lIl5ZzTpszU-x1lYkgpgntshhK5TVbmZOV9spl992_3j-TfKDNwtgPWvoPN_03y8utip_wDz7yvlw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2641333184</pqid></control><display><type>article</type><title>The use of, and outcomes for, inflammatory bowel disease services during the Covid‐19 pandemic: a nationwide observational study</title><source>MEDLINE</source><source>Wiley Online Library Free Content</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Wiley Online Library All Journals</source><creator>Deputy, Mohammed ; Sahnan, Kapil ; Worley, Guy ; Patel, Komal ; Balinskaite, Violeta ; Bottle, Alex ; Aylin, Paul ; Burns, Elaine M ; Hart, Ailsa ; Faiz, Omar</creator><creatorcontrib>Deputy, Mohammed ; Sahnan, Kapil ; Worley, Guy ; Patel, Komal ; Balinskaite, Violeta ; Bottle, Alex ; Aylin, Paul ; Burns, Elaine M ; Hart, Ailsa ; Faiz, Omar</creatorcontrib><description>Background
Inflammatory bowel disease (IBD) services have been particularly affected by the Covid‐19 pandemic. Delays in referral to secondary care and access to investigations and surgery have been exacerbated.
Aims
To investigate the use of and outcomes for emergency IBD care during the Covid‐19 pandemic.
Methods
Nationwide observational study using administrative data for England (2015‐2020) comparing cohorts admitted from 1 January 2015, to 31 January 2020 (pre‐pandemic) and from 1 February 2020, to 31 January 2021 (pandemic). Autoregressive integrated moving average forecast models were run to estimate the counterfactual IBD admissions and procedures for February 2020 to January 2021.
Results
Large decreases in attendances to hospital for emergency treatment were observed for both acute ulcerative colitis (UC, 16.4%) and acute Crohn’s disease (CD, 8.7%). The prevalence of concomitant Covid‐19 during the same episode was low [391/16 494 (2.4%) and 349/15 613 (2.2%), respectively]. No significant difference in 30‐day mortality was observed. A shorter median length of stay by 1 day for acute IBD admissions was observed (P < 0.0001). A higher rate of emergency readmission within 28 days for acute UC was observed (14.1% vs 13.4%, P = 0.012). All IBD procedures and investigations showed decreases in volume from February 2020 to January 2021 compared with counterfactual estimates. The largest absolute deficit was in endoscopy (17 544 fewer procedures, 35.2% reduction).
Conclusion
There is likely a significant burden of untreated IBD in the community. Patients with IBD may experience clinical harm or protracted decreases in quality of life if care is not prioritised.
The use of, and outcomes for, inflammatory bowel disease services during the Covid‐19 pandemic.</description><identifier>ISSN: 0269-2813</identifier><identifier>EISSN: 1365-2036</identifier><identifier>DOI: 10.1111/apt.16800</identifier><identifier>PMID: 35132663</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Colitis, Ulcerative - epidemiology ; COVID-19 ; COVID-19 - epidemiology ; Crohn's disease ; Endoscopy ; Humans ; IBD Services Utilisation during Covid‐19 Pandemic ; Inflammatory bowel disease ; Inflammatory bowel diseases ; Inflammatory Bowel Diseases - complications ; Inflammatory Bowel Diseases - epidemiology ; Inflammatory Bowel Diseases - therapy ; Intestine ; Observational studies ; Original ; Pandemics ; Quality of Life ; surgery ; Ulcerative colitis</subject><ispartof>Alimentary pharmacology & therapeutics, 2022-04, Vol.55 (7), p.836-846</ispartof><rights>2022 The Authors. published by John Wiley & Sons Ltd.</rights><rights>2022 The Authors. Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd.</rights><rights>2022. This article is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4430-35d78727986613ef70fb979e0159d1800bbcc2364b5f68764c4334fbfdeaa32b3</citedby><cites>FETCH-LOGICAL-c4430-35d78727986613ef70fb979e0159d1800bbcc2364b5f68764c4334fbfdeaa32b3</cites><orcidid>0000-0003-3885-5752 ; 0000-0003-4990-8434 ; 0000-0002-8265-7641</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fapt.16800$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fapt.16800$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,1416,1432,27923,27924,45573,45574,46408,46832</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35132663$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Deputy, Mohammed</creatorcontrib><creatorcontrib>Sahnan, Kapil</creatorcontrib><creatorcontrib>Worley, Guy</creatorcontrib><creatorcontrib>Patel, Komal</creatorcontrib><creatorcontrib>Balinskaite, Violeta</creatorcontrib><creatorcontrib>Bottle, Alex</creatorcontrib><creatorcontrib>Aylin, Paul</creatorcontrib><creatorcontrib>Burns, Elaine M</creatorcontrib><creatorcontrib>Hart, Ailsa</creatorcontrib><creatorcontrib>Faiz, Omar</creatorcontrib><title>The use of, and outcomes for, inflammatory bowel disease services during the Covid‐19 pandemic: a nationwide observational study</title><title>Alimentary pharmacology & therapeutics</title><addtitle>Aliment Pharmacol Ther</addtitle><description>Background
Inflammatory bowel disease (IBD) services have been particularly affected by the Covid‐19 pandemic. Delays in referral to secondary care and access to investigations and surgery have been exacerbated.
Aims
To investigate the use of and outcomes for emergency IBD care during the Covid‐19 pandemic.
Methods
Nationwide observational study using administrative data for England (2015‐2020) comparing cohorts admitted from 1 January 2015, to 31 January 2020 (pre‐pandemic) and from 1 February 2020, to 31 January 2021 (pandemic). Autoregressive integrated moving average forecast models were run to estimate the counterfactual IBD admissions and procedures for February 2020 to January 2021.
Results
Large decreases in attendances to hospital for emergency treatment were observed for both acute ulcerative colitis (UC, 16.4%) and acute Crohn’s disease (CD, 8.7%). The prevalence of concomitant Covid‐19 during the same episode was low [391/16 494 (2.4%) and 349/15 613 (2.2%), respectively]. No significant difference in 30‐day mortality was observed. A shorter median length of stay by 1 day for acute IBD admissions was observed (P < 0.0001). A higher rate of emergency readmission within 28 days for acute UC was observed (14.1% vs 13.4%, P = 0.012). All IBD procedures and investigations showed decreases in volume from February 2020 to January 2021 compared with counterfactual estimates. The largest absolute deficit was in endoscopy (17 544 fewer procedures, 35.2% reduction).
Conclusion
There is likely a significant burden of untreated IBD in the community. Patients with IBD may experience clinical harm or protracted decreases in quality of life if care is not prioritised.
The use of, and outcomes for, inflammatory bowel disease services during the Covid‐19 pandemic.</description><subject>Colitis, Ulcerative - epidemiology</subject><subject>COVID-19</subject><subject>COVID-19 - epidemiology</subject><subject>Crohn's disease</subject><subject>Endoscopy</subject><subject>Humans</subject><subject>IBD Services Utilisation during Covid‐19 Pandemic</subject><subject>Inflammatory bowel disease</subject><subject>Inflammatory bowel diseases</subject><subject>Inflammatory Bowel Diseases - complications</subject><subject>Inflammatory Bowel Diseases - epidemiology</subject><subject>Inflammatory Bowel Diseases - therapy</subject><subject>Intestine</subject><subject>Observational studies</subject><subject>Original</subject><subject>Pandemics</subject><subject>Quality of Life</subject><subject>surgery</subject><subject>Ulcerative colitis</subject><issn>0269-2813</issn><issn>1365-2036</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>EIF</sourceid><recordid>eNp1kctq3DAUhkVoaaZpF3mBIsgmhTjRxZbtLAJh6A0C6WK6FrocJQq2NZXsGWZX-gR9xj5JNZk0NIFqI4S-8-kc_QgdUnJK8zpTy_GUioaQPTSjXFQFI1y8QDPCRFuwhvJ99DqlO0KIqAl7hfZ5RTkTgs_Qz8Ut4CkBDu4Eq8HiMI0m9JCwC_EE-8F1qu_VGOIG67CGDlufQOWCBHHlTQbtFP1wg8csmoeVt79__KItXmYZ9N6cY4UHNfowrL3Nz-ht3f1ZdTiNk928QS-d6hK8fdgP0LePHxbzz8XV9acv88urwpQlJwWvbN3UrG4bISgHVxOn27oFQqvW0jy81sYwLkpdOdHUojQl56XTzoJSnGl-gC523uWke7AGhjGqTi6j71XcyKC8fHoz-Ft5E1ayzX-cO8iC4wdBDN8nSKPsfTLQdWqAMCXJBBNNy2hdZfToGXoXpphH3lIl5ZzTpszU-x1lYkgpgntshhK5TVbmZOV9spl992_3j-TfKDNwtgPWvoPN_03y8utip_wDz7yvlw</recordid><startdate>202204</startdate><enddate>202204</enddate><creator>Deputy, Mohammed</creator><creator>Sahnan, Kapil</creator><creator>Worley, Guy</creator><creator>Patel, Komal</creator><creator>Balinskaite, Violeta</creator><creator>Bottle, Alex</creator><creator>Aylin, Paul</creator><creator>Burns, Elaine M</creator><creator>Hart, Ailsa</creator><creator>Faiz, Omar</creator><general>Wiley Subscription Services, Inc</general><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>M7N</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-3885-5752</orcidid><orcidid>https://orcid.org/0000-0003-4990-8434</orcidid><orcidid>https://orcid.org/0000-0002-8265-7641</orcidid></search><sort><creationdate>202204</creationdate><title>The use of, and outcomes for, inflammatory bowel disease services during the Covid‐19 pandemic: a nationwide observational study</title><author>Deputy, Mohammed ; Sahnan, Kapil ; Worley, Guy ; Patel, Komal ; Balinskaite, Violeta ; Bottle, Alex ; Aylin, Paul ; Burns, Elaine M ; Hart, Ailsa ; Faiz, Omar</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4430-35d78727986613ef70fb979e0159d1800bbcc2364b5f68764c4334fbfdeaa32b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Colitis, Ulcerative - epidemiology</topic><topic>COVID-19</topic><topic>COVID-19 - epidemiology</topic><topic>Crohn's disease</topic><topic>Endoscopy</topic><topic>Humans</topic><topic>IBD Services Utilisation during Covid‐19 Pandemic</topic><topic>Inflammatory bowel disease</topic><topic>Inflammatory bowel diseases</topic><topic>Inflammatory Bowel Diseases - complications</topic><topic>Inflammatory Bowel Diseases - epidemiology</topic><topic>Inflammatory Bowel Diseases - therapy</topic><topic>Intestine</topic><topic>Observational studies</topic><topic>Original</topic><topic>Pandemics</topic><topic>Quality of Life</topic><topic>surgery</topic><topic>Ulcerative colitis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Deputy, Mohammed</creatorcontrib><creatorcontrib>Sahnan, Kapil</creatorcontrib><creatorcontrib>Worley, Guy</creatorcontrib><creatorcontrib>Patel, Komal</creatorcontrib><creatorcontrib>Balinskaite, Violeta</creatorcontrib><creatorcontrib>Bottle, Alex</creatorcontrib><creatorcontrib>Aylin, Paul</creatorcontrib><creatorcontrib>Burns, Elaine M</creatorcontrib><creatorcontrib>Hart, Ailsa</creatorcontrib><creatorcontrib>Faiz, Omar</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Wiley Online Library Free Content</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Alimentary pharmacology & therapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Deputy, Mohammed</au><au>Sahnan, Kapil</au><au>Worley, Guy</au><au>Patel, Komal</au><au>Balinskaite, Violeta</au><au>Bottle, Alex</au><au>Aylin, Paul</au><au>Burns, Elaine M</au><au>Hart, Ailsa</au><au>Faiz, Omar</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The use of, and outcomes for, inflammatory bowel disease services during the Covid‐19 pandemic: a nationwide observational study</atitle><jtitle>Alimentary pharmacology & therapeutics</jtitle><addtitle>Aliment Pharmacol Ther</addtitle><date>2022-04</date><risdate>2022</risdate><volume>55</volume><issue>7</issue><spage>836</spage><epage>846</epage><pages>836-846</pages><issn>0269-2813</issn><eissn>1365-2036</eissn><abstract>Background
Inflammatory bowel disease (IBD) services have been particularly affected by the Covid‐19 pandemic. Delays in referral to secondary care and access to investigations and surgery have been exacerbated.
Aims
To investigate the use of and outcomes for emergency IBD care during the Covid‐19 pandemic.
Methods
Nationwide observational study using administrative data for England (2015‐2020) comparing cohorts admitted from 1 January 2015, to 31 January 2020 (pre‐pandemic) and from 1 February 2020, to 31 January 2021 (pandemic). Autoregressive integrated moving average forecast models were run to estimate the counterfactual IBD admissions and procedures for February 2020 to January 2021.
Results
Large decreases in attendances to hospital for emergency treatment were observed for both acute ulcerative colitis (UC, 16.4%) and acute Crohn’s disease (CD, 8.7%). The prevalence of concomitant Covid‐19 during the same episode was low [391/16 494 (2.4%) and 349/15 613 (2.2%), respectively]. No significant difference in 30‐day mortality was observed. A shorter median length of stay by 1 day for acute IBD admissions was observed (P < 0.0001). A higher rate of emergency readmission within 28 days for acute UC was observed (14.1% vs 13.4%, P = 0.012). All IBD procedures and investigations showed decreases in volume from February 2020 to January 2021 compared with counterfactual estimates. The largest absolute deficit was in endoscopy (17 544 fewer procedures, 35.2% reduction).
Conclusion
There is likely a significant burden of untreated IBD in the community. Patients with IBD may experience clinical harm or protracted decreases in quality of life if care is not prioritised.
The use of, and outcomes for, inflammatory bowel disease services during the Covid‐19 pandemic.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>35132663</pmid><doi>10.1111/apt.16800</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0003-3885-5752</orcidid><orcidid>https://orcid.org/0000-0003-4990-8434</orcidid><orcidid>https://orcid.org/0000-0002-8265-7641</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0269-2813 |
| ispartof | Alimentary pharmacology & therapeutics, 2022-04, Vol.55 (7), p.836-846 |
| issn | 0269-2813 1365-2036 |
| language | eng |
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| source | MEDLINE; Wiley Online Library Free Content; EZB-FREE-00999 freely available EZB journals; Wiley Online Library All Journals |
| subjects | Colitis, Ulcerative - epidemiology COVID-19 COVID-19 - epidemiology Crohn's disease Endoscopy Humans IBD Services Utilisation during Covid‐19 Pandemic Inflammatory bowel disease Inflammatory bowel diseases Inflammatory Bowel Diseases - complications Inflammatory Bowel Diseases - epidemiology Inflammatory Bowel Diseases - therapy Intestine Observational studies Original Pandemics Quality of Life surgery Ulcerative colitis |
| title | The use of, and outcomes for, inflammatory bowel disease services during the Covid‐19 pandemic: a nationwide observational study |
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