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Outcomes for upper gastrointestinal bleeding during the first wave of the COVID‐19 pandemic in the Toronto area
Author(s) -
Khan Rishad,
Saha Sudipta,
Gimpaya Nikko,
Bansal Rishi,
Scaffidi Michael A,
Razak Fahad,
Verma Amol A,
Grover Samir C
Publication year - 2022
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.15804
Subject(s) - medicine , pandemic , confidence interval , odds ratio , upper gastrointestinal bleeding , gastrointestinal bleeding , retrospective cohort study , intensive care , endoscopy , emergency department , cohort study , emergency medicine , covid-19 , pediatrics , intensive care medicine , disease , psychiatry , infectious disease (medical specialty)
Background and Aim Changes to endoscopy service availability during the COVID‐19 pandemic may have affected management of upper gastrointestinal bleeding (UGIB). The aim of this study was to describe the impact of the pandemic on UGIB outcomes in the Toronto area in Canada. Methods We described all adults admitted to general medicine wards or intensive care units at six hospitals in Toronto and Mississauga, Canada, with UGIB during the first wave of the COVID‐19 pandemic (March 1 to June 30, 2020) and compared them with a historical cohort (March 1 to June 30, 2018 and 2019). We compared clinical outcomes (in‐hospital mortality, length of stay, 30‐day readmission, intensive care utilization, receipt of endoscopy, persistent bleeding, receipt of second endoscopy, and need for angiographic or surgical intervention) using multivariable regression models, controlling for demographics, comorbidities, and severity of clinical presentation. Results There were 82.5 and 215.5 admissions per month for UGIB during the COVID‐19 and control periods, respectively. There were no baseline differences between groups for demographic characteristics, comorbidities, or severity of bleeding. Patients in the COVID‐19 group did not have significantly different unadjusted (3.9% vs 4.2%, P = 0.983) or adjusted mortality (adjusted odds ratio [OR] = 0.64, 95% confidence interval [CI] = 0.25–1.48, P = 0.322). Patients in COVID‐19 group were less likely to receive endoscopy for UGIB in the unadjusted (61.8% vs 71.0%, P = 0.003) and adjusted (adjusted OR = 0.64, 95% CI = 0.49–0.84, P < 0.01) models. There were no differences between groups for other secondary outcomes. Conclusions While patients admitted for UGIB during the first wave of the pandemic were less likely to receive endoscopy, this had no impact on mortality or any secondary outcomes.