Complications while Waiting for IBD Surgery - Short Report

Abstract

Background and Aims: While striving to meet the quality standards for oncological care, hospitals frequently prioritize oncological procedures, resulting in longer waiting times to surgery for benign diseases like inflammatory bowel disease [IBD]. The aim of this Short Report is to highlight the potential consequences of a longer interval to surgery for IBD patients. Methods: The mean waiting times to elective surgery for IBD patients with active and inactive disease [e.g. pouch surgery after subtotal colectomy] at the Amsterdam UMC, location AMC, between 2013 and 2015 were compared with those for colorectal cancer surgery. Correlations between IBD waiting times and disease complications [e.g. >5% weight loss, abscess formation] and additional health-care consumption [e.g. telephone/outpatient clinic appointment, hospital admission] during these waiting times were assessed. Results: The mean waiting was 10 weeks [SD 8] for patients with active disease [n = 173] and 15 weeks [SD 16] for those with inactive disease [n = 97], remarkably higher than that for colorectal cancer patients [5 weeks]. While awaiting surgery, 1 out of 8 patients had to undergo surgery in an acute or semi-acute setting. Additionally, 19% of patients with active disease had disease complications, and 44% needed additional health care. The rates were comparable for patients with inactive disease. Conclusions: The current waiting time to surgery is not medically justified and creates a burden for health-care resources. This issue should be brought to the attention of policy makers, as it requires a structural solution. It is time to also set a maximally acceptable waiting time to surgery for IBD patients.