Hütf Çocuk Gastroenteroloji, Hepatoloji ve Beslenme Bölümünde Yapılan Girişimsel İşlemlerin, Covıd-19 Pandemisi Öncesi ve Sonrasında, Sayısal ve Niteliksel Olarak Karşılaştırılması

Abstract

Deveci, K. Quantitative and Qualitative Comparison of Interventional Procedures in the Department of Pediatric Gastroenterology, Hepatology and Nutrition at HUFM Before and After the COVID-19 Pandemic. Hacettepe University Faculty of Medicine, Child Health and Diseases Specialty Thesis, Ankara 2023. The pandemic was declared by the World Health Organization (WHO) in March 2020 due to the “Coronavirus Disease of 2019 (COVID-19” infection caused by the severe acute respiratory syndrome resulting from coronavirus-2 (SARS-CoV-2). The COVID-19 pandemic has created difficulties in the functioning of pediatric gastroenterology clinics in which interventional procedures such as endoscopy are performed. In our study, interventional procedures carried out in Hacettepe University Faculty of Medicine, Department of Pediatric Gastroenterology, Hepatology, and Nutrition were compared both numerically and in terms of procedure indications before and after the COVID-19 pandemic. Between 12 March 2019 - 11 March 2020 (the first-period) and 12 March 2020 - 11 March 2021 (the second-period), the total number of appointments was 527. Of these, 366 (69%) were given an appointment for the first-period and 161 (31%) for the second-period. The number of appointments in the second period was significantly less (p<0,001). The median age of the patients having a first-period procedure appointment was 11,16 years (5,75-15,00), and the median age of the patients having a second-period procedure appointment was 10,75 years (6,17-14,55). The procedure with the most appointments in both periods was "esophagogastroduodenoscopy". Considering the comparison of patients' age according to the type of procedure; the lowest median age of patients for the first-period belonged to the patients undergoing liver biopsy (6,2 years), and the highest median age of the patients undergoing colonoscopy (12,3 years). While a significant difference was observed between the ages of the patients according to the type of procedure for the first-period (p=0,003), this difference was not significant for the second-period. There was a significant difference between performed and postponed procedures between the two periods. The rate of postponed procedures was higher in the second period (p=0,045). In the first-period, 74 (20,2%) of 133 procedures not performed at the first appointment, and 50 (31,1%) of 74 procedures not performed at the first appointment in the second-period were postponed to a later date than the first appointment date. Examination of the comparison of the delay time of the postponed and future procedures in terms of the first appointment date, a significant difference was detected between the two periods (p<0,001). The median delay time in the first-period was one month, and the median delay time in the second-period was five months. Significant results were noted in three (2,3%) patients whose procedure was postponed in the first-period and in six (8,1%) patients whose procedure was postponed in the second-period. The difference was not significant (p=0,13). The most frequent appointment indications for first-period patients were “inflammatory bowel disease (IBD)” and "chronic liver disease" diagnosis/pre-diagnosis. In the second-term, the most frequent reason for making a procedure appointment was “IBD”. The most common cause for postponement in the first-period procedures was “infection” and in the second-period procedures was the “COVID-19 Pandemic”. The difference between the reasons for the postponement of the two periods was found to be significant (p<0,001). Our study is the first study conducted in our center to examine the effect of the COVID-19 period on gastrointestinal interventional procedures in children. It is thought that our study will provide valuable implications for pediatric gastroenterologists.

Keywords: COVID-19 pandemic, child, pediatric gastroenterology, interventional procedure, endoscopy