Impact of pandemic and socioeconomic influences on decision-making for emergency ostomy procedures: Key factors affecting hospital visit decisions

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dc.authoridAkbulut, Sami/0000-0002-6864-7711
dc.authoridUmman, Veysel/0000-0003-1760-7346
dc.authorwosidAkbulut, Sami/L-9568-2014
dc.authorwosidUmman, Veysel/KDN-0902-2024
dc.contributor.authorUmman, Veysel
dc.contributor.authorGirgin, Tolga
dc.contributor.authorBaki, Bahadir Emre
dc.contributor.authorBozbiyik, Osman
dc.contributor.authorAkbulut, Sami
dc.contributor.authorYoldas, Tayfun
dc.date.accessioned2024-08-04T20:56:08Z
dc.date.available2024-08-04T20:56:08Z
dc.date.issued2024
dc.departmentİnönü Üniversitesien_US
dc.description.abstractEmergency surgeries are linked with increased morbidity and reduced life expectancy, often associated with low socioeconomic status, limited access to healthcare, and delayed hospital admissions. While the influence of socioeconomic status on elective surgery outcomes is well-established, its impact on emergency surgeries, including ostomy creation and closure, is less clear. This study aimed to explore how the pandemic and socioeconomic status affect emergency ostomy procedures, seeking to determine which has a greater effect. It emphasizes the importance of considering socioeconomic factors in patient care pathways for ostomy procedures. A total of 542 patients who underwent emergency ostomy formation between 2016 and 2022 were retrospectively analyzed and divided into pre-pandemic and pandemic periods. The pre-pandemic and pandemic periods were compared between themselves and against each other. Demographic data (age and sex), comorbidities, socioeconomic status, etiology of the primary disease, type of surgery, stoma type, length of hospital stay, ostomy closure time, and postoperative complications were retrospectively analyzed for all patients. In total, 290 (53%) patients underwent surgery during the pandemic period, whereas 252 (47%) underwent surgery during the pre-pandemic period. Emergency surgery was performed for malignancy in 366 (67%) patients. The number of days patients underwent ostomy closure was significantly higher in the low-income group (P = .038, 95% CI: 293,2, 386-945). The risk of failure of stoma closure was 3-fold (95% CI: 1.8-5.2) in patients with metastasis. The risk of mortality was 12.4-fold (95% CI: 6.5-23.7) when there was failure of stoma closure. When compared to pandemic period, the mortality risk was 6.3-fold (95% CI: 3.9-10.2) in pre-pandemic period. Pandemic patients had a shorter hospital stay than before the pandemic (P = .044). A high socioeconomic status was significantly associated with early hospital admission for ostomy closure, and lower probability of mortality. More metastases and perforations were observed during the pandemic period and mortality was increased during pandemic and in patients without ostomy closure. The socioeconomic status lost its effect in cases of emergency ostomy creation and had no impact on length of hospital stay in either the pre-pandemic or pandemic period.en_US
dc.identifier.doi10.1097/MD.0000000000038706
dc.identifier.issn0025-7974
dc.identifier.issn1536-5964
dc.identifier.issue26en_US
dc.identifier.pmid38941379en_US
dc.identifier.scopus2-s2.0-85197167664en_US
dc.identifier.scopusqualityQ3en_US
dc.identifier.urihttps://doi.org/10.1097/MD.0000000000038706
dc.identifier.urihttps://hdl.handle.net/11616/102084
dc.identifier.volume103en_US
dc.identifier.wosWOS:001266661100003en_US
dc.identifier.wosqualityN/Aen_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherLippincott Williams & Wilkinsen_US
dc.relation.ispartofMedicineen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectCOVID-19en_US
dc.subjectemergency ostomyen_US
dc.subjectostomy closureen_US
dc.subjectpandemicen_US
dc.subjectsocioeconomic statusen_US
dc.titleImpact of pandemic and socioeconomic influences on decision-making for emergency ostomy procedures: Key factors affecting hospital visit decisionsen_US
dc.typeArticleen_US

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