Komatsu Takumi, Sato Yoshinori, Tanabe Kenichiro, Ishida Jun, Nakamoto Yusuke, Kato Masaki, Kiyokawa Hirofumi, Yoshida Yoshihito, Kuroki Yuichiro, Maehata Tadateru, Yasuda Hiroshi, Matsumoto Nobuyuki, Tateishi Keisuke
Department of Gastroenterology, St. Marianna University School of Medicine, Kawasaki, Japan.
Department of Gastroenterology, St. Marianna University School of Medicine, Yokohama Seibu Hospital, Yokohama, Japan.
J Anus Rectum Colon. 2024 Oct 25;8(4):403-410. doi: 10.23922/jarc.2024-044. eCollection 2024.
This study evaluated the endoscopic management and clinical outcomes of patients with colonic diverticular bleeding (CDB) during the coronavirus disease 2019 (COVID-19) pandemic.
A total of 388 hospitalized patients diagnosed with CDB at two hospitals during (April 2020-March 2023) and before (April 2017-March 2020) the pandemic were enrolled in the study. We performed one-to-one propensity score matching (PSM) on the participants. We analyzed endoscopic management and clinical outcomes before and during the pandemic using a total of 264 patients matched in a PSM analysis.
A total of 213 (1.3%) and 172 (1.2%) colonoscopies were performed before and during the pandemic, respectively in patients with CDB (P = 0.70). After PSM, the number of early colonoscopies (63.6% vs. 76.5%, P = 0.03) and colonoscopies performed outside regular working hours (23.8% vs. 47.7%, P < 0.01) was significantly lower during the pandemic than before it. A univariate logistic regression analysis revealed that the risks of rebleeding within 30 days (odds ratio [OR]: 0.81, P = 0.42) and composite outcome (OR: 0.90, P = 0.69) were not increased during the pandemic.
During the pandemic, the number of early colonoscopies and colonoscopies performed outside regular working hours decreased; however, this decrease did not influence rebleeding and composite outcome in patients with CDB.
本研究评估了2019冠状病毒病（COVID-19）大流行期间结肠憩室出血（CDB）患者的内镜治疗及临床结局。
共有388例在两家医院住院的患者纳入本研究，这些患者在大流行期间（2020年4月至2023年3月）及之前（2017年4月至2020年3月）被诊断为CDB。我们对参与者进行了一对一倾向评分匹配（PSM）。我们使用PSM分析中匹配的264例患者，分析了大流行之前和期间的内镜治疗及临床结局。
CDB患者在大流行之前和期间分别进行了213例（1.3%）和172例（1.2%）结肠镜检查（P = 0.70）。PSM后，大流行期间早期结肠镜检查的数量（63.6%对76.5%，P = 0.03）和非工作时间进行的结肠镜检查数量（23.8%对47.7%，P < 0.01）显著低于大流行之前。单因素逻辑回归分析显示，大流行期间30天内再出血风险（比值比[OR]：0.81，P = 0.42）和复合结局风险（OR：0.90，P = 0.69）未增加。
在大流行期间，早期结肠镜检查和非工作时间进行的结肠镜检查数量减少；然而，这种减少并未影响CDB患者的再出血和复合结局。
