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IMPACT OF THE COVID-19 PANDEMIC ON ENDOSCOPY CANCELLATIONS
Gastroenterology ; 160(6):S-215, 2021.
Article in English | EMBASE | ID: covidwho-1599091
ABSTRACT

Background:

The coronavirus disease 19 (COVID-19) pandemic has disrupted healthcare delivery including cancellation of elective endoscopy. Despite the implementation of safety protocols to limit COVID-19 spread in endoscopy units, significant fear of infection remains among patients. We aimed to determine the prevalence of endoscopy cancellations in the COVID-19 era and identify patient characteristics associated with cancellation due to the pandemic.

Methods:

Medical charts were reviewed for adults who cancelled a scheduled endoscopic procedure from 5/2020-8/2020 at a tertiary care academic center. Inpatient endoscopies were excluded. Reasons for cancellation were categorized as COVID-19 related, non-COVID-19 related, or unclear. COVID-19 related cancellations were further categorized as COVID-19 testing logistics related, COVID-19 fear related, or other. The association of patient characteristics with cancellation of endoscopy due to COVID-19 were assessed using logistic regression.

Results:

652 patient charts were reviewed. Median age was 58, with55% female, 61% non-Hispanic white, 11% had IBD, and 16% were immunosuppressed.Procedure types included 120 (18%) upper endoscopies (EGD), 362 (56%) colonoscopies, 93 (14%) EGD/colonoscopies, 20 (3%) sigmoidoscopies, and 57 (9%) advanced endoscopic procedures. 211 (32%) cancellations were due to COVID-19, 384 (59%) were due to non-COVID-19 reasons, and 57 (9%) were undetermined. Among COVID-19 related cancellations, 75 (36%) were COVID-19 testing logistics related, 121 (57%) were COVID-19 fear related, and 15 (7%) were other. On multivariate analysis, the odds of cancellation due to COVID-19 was significantly higher for black patients (OR 2.01, 95% CI 1.05-3.86, p=0.04), while patients undergoing EGD (OR 0.50, 95% CI 0.28-0.89, p=0.02) or advanced endoscopy (OR 0.18, 95% CI 0.07-0.49, p=0.001) had lower odds of cancellation [Table 1]. The odds of cancelling due to COVID-19 testing was significantly higher among black patients (OR 3.12, 95% CI 1.03-9.46, p=0.05), patients with Medi-Cal insurance (OR 2.89, 95% CI 1.21-6.89, p=0.02), and patients undergoing sigmoidoscopy (OR 11.6, 95% CI 1.23-108.5, p=0.03) and diagnostic indications (OR 2.96, 95% CI 1.22-7.21, p=0.02). Patients with older age (≥65) had higher odds of COVID-19 fear related cancellation (OR 0.29, 95% CI 0.10-0.81, p=0.02) [Table 2].

Conclusion:

COVID-19 has negatively impacted endoscopy scheduling. Diagnostic or therapeutic procedures are associated with a lower risk of cancellation related to COVID-19. Black race is associated with an increased risk of COVID-19 related cancellation. Specifically, black patients and those with Medi-Cal are at increased risk of cancellation related to COVID-19 testing logistics. Racial and socioeconomic disparities in access to endoscopy may be further amplified by the COVID-19 pandemic and warrant further study.(Table Presented)(Table Presented)
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Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Experimental Studies Language: English Journal: Gastroenterology Year: 2021 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Experimental Studies Language: English Journal: Gastroenterology Year: 2021 Document Type: Article