Teagan Telesnicki, Therese A Stukel, Anthony de Buck van Overstraeten, Andrew Wilton, Charles de Mestral, David Gomez
{"title":"评估憩室炎预定结肠手术积压与紧急憩室炎手术并发率之间的关系：一项基于人群数据的自然实验。","authors":"Teagan Telesnicki, Therese A Stukel, Anthony de Buck van Overstraeten, Andrew Wilton, Charles de Mestral, David Gomez","doi":"10.1016/j.gassur.2025.102257","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Utilizing the natural experiment of the COVID-19 pandemic disruption of scheduled surgery, this study evaluated the association between the reduction in planned scheduled colectomies for diverticulitis and concurrent rates of emergency diverticulitis procedures in Ontario, Canada, compared to a 3-year baseline period of normal scheduled surgical delivery.</p><p><strong>Methods: </strong>This population-based repeated cross-sectional study was inclusive of all adults presenting to any emergency department (ED) with diverticulitis or undergoing scheduled colectomy for colonic diverticulitis between Mar.1,2020-Aug.31,2022. Poisson generalized estimating equation models were used to model the three-year baseline trends (Jan.1,2017-Feb.28,2020 - no surgical disruption) and predict expected trends had the pandemic not occurred. Relative change between the observed and expected population-rates was expressed as an adjusted relative rate (aRR), and reported for: scheduled colectomies, hospital admissions, urgent surgery and the composite of urgent surgery, percutaneous drain, or 30-day all-cause mortality.</p><p><strong>Results: </strong>Observed population rates of scheduled colectomies for diverticulitis decreased by 19% (aRR 0.81, 95%CI 0.67-0.99), equating to 211 fewer scheduled surgeries. Concurrently, urgent hospital admissions decreased by 15% (aRR 0.85 95%CI 0.83-0.88), and there was no sustained difference in population rates of urgent surgery for diverticulitis or the composite outcome.</p><p><strong>Discussion: </strong>Despite a significant change in the delivery of scheduled surgery leading to a 19% decrease in scheduled colectomy rates, no significant change in the concurrent population rate of urgent surgery or in the composite outcome of urgent surgery or percutaneous drainage or mortality within 30 days was observed compared to a 3-year stable baseline of stable surgical delivery.</p>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":" ","pages":"102257"},"PeriodicalIF":2.4000,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Evaluating the association between a backlog of scheduled colectomies for diverticulitis and concurrent rates of emergency diverticulitis procedures: A natural experiment using population-based data.\",\"authors\":\"Teagan Telesnicki, Therese A Stukel, Anthony de Buck van Overstraeten, Andrew Wilton, Charles de Mestral, David Gomez\",\"doi\":\"10.1016/j.gassur.2025.102257\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Utilizing the natural experiment of the COVID-19 pandemic disruption of scheduled surgery, this study evaluated the association between the reduction in planned scheduled colectomies for diverticulitis and concurrent rates of emergency diverticulitis procedures in Ontario, Canada, compared to a 3-year baseline period of normal scheduled surgical delivery.</p><p><strong>Methods: </strong>This population-based repeated cross-sectional study was inclusive of all adults presenting to any emergency department (ED) with diverticulitis or undergoing scheduled colectomy for colonic diverticulitis between Mar.1,2020-Aug.31,2022. Poisson generalized estimating equation models were used to model the three-year baseline trends (Jan.1,2017-Feb.28,2020 - no surgical disruption) and predict expected trends had the pandemic not occurred. Relative change between the observed and expected population-rates was expressed as an adjusted relative rate (aRR), and reported for: scheduled colectomies, hospital admissions, urgent surgery and the composite of urgent surgery, percutaneous drain, or 30-day all-cause mortality.</p><p><strong>Results: </strong>Observed population rates of scheduled colectomies for diverticulitis decreased by 19% (aRR 0.81, 95%CI 0.67-0.99), equating to 211 fewer scheduled surgeries. Concurrently, urgent hospital admissions decreased by 15% (aRR 0.85 95%CI 0.83-0.88), and there was no sustained difference in population rates of urgent surgery for diverticulitis or the composite outcome.</p><p><strong>Discussion: </strong>Despite a significant change in the delivery of scheduled surgery leading to a 19% decrease in scheduled colectomy rates, no significant change in the concurrent population rate of urgent surgery or in the composite outcome of urgent surgery or percutaneous drainage or mortality within 30 days was observed compared to a 3-year stable baseline of stable surgical delivery.</p>\",\"PeriodicalId\":15893,\"journal\":{\"name\":\"Journal of Gastrointestinal Surgery\",\"volume\":\" \",\"pages\":\"102257\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2025-10-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Gastrointestinal Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.gassur.2025.102257\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Gastrointestinal Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.gassur.2025.102257","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Evaluating the association between a backlog of scheduled colectomies for diverticulitis and concurrent rates of emergency diverticulitis procedures: A natural experiment using population-based data.
Introduction: Utilizing the natural experiment of the COVID-19 pandemic disruption of scheduled surgery, this study evaluated the association between the reduction in planned scheduled colectomies for diverticulitis and concurrent rates of emergency diverticulitis procedures in Ontario, Canada, compared to a 3-year baseline period of normal scheduled surgical delivery.
Methods: This population-based repeated cross-sectional study was inclusive of all adults presenting to any emergency department (ED) with diverticulitis or undergoing scheduled colectomy for colonic diverticulitis between Mar.1,2020-Aug.31,2022. Poisson generalized estimating equation models were used to model the three-year baseline trends (Jan.1,2017-Feb.28,2020 - no surgical disruption) and predict expected trends had the pandemic not occurred. Relative change between the observed and expected population-rates was expressed as an adjusted relative rate (aRR), and reported for: scheduled colectomies, hospital admissions, urgent surgery and the composite of urgent surgery, percutaneous drain, or 30-day all-cause mortality.
Results: Observed population rates of scheduled colectomies for diverticulitis decreased by 19% (aRR 0.81, 95%CI 0.67-0.99), equating to 211 fewer scheduled surgeries. Concurrently, urgent hospital admissions decreased by 15% (aRR 0.85 95%CI 0.83-0.88), and there was no sustained difference in population rates of urgent surgery for diverticulitis or the composite outcome.
Discussion: Despite a significant change in the delivery of scheduled surgery leading to a 19% decrease in scheduled colectomy rates, no significant change in the concurrent population rate of urgent surgery or in the composite outcome of urgent surgery or percutaneous drainage or mortality within 30 days was observed compared to a 3-year stable baseline of stable surgical delivery.
期刊介绍：
The Journal of Gastrointestinal Surgery is a scholarly, peer-reviewed journal that updates the surgeon on the latest developments in gastrointestinal surgery. The journal includes original articles on surgery of the digestive tract; gastrointestinal images; "How I Do It" articles, subject reviews, book reports, editorial columns, the SSAT Presidential Address, articles by a guest orator, symposia, letters, results of conferences and more. This is the official publication of the Society for Surgery of the Alimentary Tract. The journal functions as an outstanding forum for continuing education in surgery and diseases of the gastrointestinal tract.
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