P620 Pivoting in a pandemic: The impact of COVID-19 on the provision of care for patients with Inflammatory Bowel Disease – A retrospective study
Notice bibliographique
Résumé
Abstract Background The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak, also known as COVID-19, initially began in a small cluster of patients in Wuhan, China and was declared a worldwide pandemic in March of 2020. Since the onset of the pandemic, the focus of many healthcare systems has shifted toward limiting non-essential visits to the hospital in order to prioritize and allocate resources toward treating those affected by COVID-19. While the effect of COVID-19 has been felt amongst many patient populations, those with Inflammatory Bowel Disease (IBD) have been particularly impacted. We aimed to determine how changes to the provision of IBD care due to the COVID-19 pandemic has affected IBD patients. Methods A retrospective cohort study was carried out in patients with an IBD diagnosis comparing patients admitted to two tertiary care centres affiliated with Western University in London, Canada between March 17 and August 31 2019 (2019 cohort or pre-pandemic), to patients admitted between March 17 and August 31 2020 (2020 cohort or pandemic). Patients were reviewed to assess any differences in care utilization and IBD-related outcomes such as hospitalization, need for surgery, length of stay in hospital and in-patient drug therapy during the defined time periods. Results A total of 863 patients were reviewed in 2019, and 554 in 2020. Of those, 184 (CD, n= 125; UC, n= 59) and 172 (CD, n= 109; UC, n= 62) encounters met the inclusion criteria for 2019 and 2020 respectively. Patient demographics were similar between 2019 and 2020 cohort with the exception of age (2019, mean age = 44.76 years ± 16.78; 2020, mean age=50.36 years ± 17.82, p=0.002). The length of stay in hospital was shorter in 2020 (6.88 days vs 9.63, p=0.045). Significantly fewer patients were initiated on Infliximab in hospital in 2020 (2020, 3.50 per month; 2019, 6.83 per month, p=0.001). Fewer in-patient surgeries were performed in 2020 (2019, 76; 2020, 57; p=0.112). Conclusion Preliminary data demonstrate during the COVID-19 pandemic there was a significant reduction in the length of stay for patients with IBD as well as fewer patients initiated on infliximab while in hospital. There was also a decrease in the number of surgeries performed in 2020. These differences may reflect an effort to minimize contact between patients and health care facilities as well as reduce the introduction of further immunosuppression. Further research will be to determine whether if more ER visits became hospitalizations and any delays in appointment times or endoscopies, or compliance issues with medications may have led to these aforementioned outcomes.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».