Complications while waiting for IBD surgery- short report.

Wasmann, Karin A

BACKGROUND AND AIMS While striving to meet the quality standards for oncological care, hospitals prioritize oncological procedures more frequently, 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 time 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 2013-2015 were compared to colorectal cancer surgery. The IBD waiting times were correlated to 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. 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 compared to colorectal cancer patients (5 weeks). While awaiting surgery, 1 out of 8 patients had to undergo surgery in an (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.