Patients were sicker upon presentation, had longer surgeries and more complications
FRIDAY, Oct. 21, 2022 (HealthDay News) — During the pandemic, surgical volumes decreased, but the clinical presentation of diverticulitis became more severe, according to a study presented at the Scientific Forum of the American College of Surgeons Clinical Congress 2022, held from Oct. 16 to 20 in San Diego.
Rolando H. Rolandelli, M.D., from Morristown Medical Center in New Jersey, and colleagues identified 23,383 patients who underwent a colectomy for diverticulitis in 2018 (control year) and 2020 (pandemic year) and compared differences in disease severity, comorbidities, perioperative factors, and complications.
The researchers found that during the pandemic, colonic operations for diverticulitis decreased by 13.1 percent. During the pandemic, there were fewer White patients with diverticulitis (P < 0.001) but more Black/African American (P = 0.032) and Hispanic patients (P < 0.001). During the pandemic, there were increases in the rates of congestive heart failure, acute renal failure, systemic inflammatory response syndrome, and septic shock (P < 0.05). There were also more emergency operations (17.3 percent versus 20.0 percent; P < 0.001) and cases with a known abscess or perforation (50.1 percent versus 54.5 percent; P < 0.001). There were more patients during the pandemic classified as American Society of Anesthesiology classes 3, 4, and 5, who required longer operations (P < 0.001) and developed more complications, such as organ space surgical site infection, wound disruption, pneumonia, acute renal failure, septic shock, and myocardial infarction (P < 0.05).
“This underscores the importance of monitoring patients at risk for diverticulitis and intervening when criteria for surgery are met,†the authors write.
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