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1. Global trends in opioid use for pain management in acute pancreatitis: A multicentre prospective observational study

Author

Knoph, Cecilie Siggaard, Lucocq, James, Kamarajah, Sivesh Kathir, Olesen, Søren Schou, Jones, Michael, Samanta, Jayanta, Talukdar, Rupjyoti, Capurso, Gabriele, de‐Madaria, Enrique, Yadav, Dhiraj, Siriwardena, Ajith K., Windsor, John, Drewes, Asbjørn Mohr, Nayar, Manu, Cark, Neil, Pius, Riinu, Houghton, Eduardo, Gimenéz, Mariano, Uribe, Karla, Rodriguez, Florencia, Gundara, Justin, Mackay, Thomas, Phan, Huynh, Lewin, Joel, McElhatton, Claire, Siriwardhane, Mehan, Hodgson, Russell, Malik, Hassan, Ward, Ryan, Young, Kerilee, Bappayya, Shaneel, Loveday, Benjamin, Samra, Jaswinder, Gall, Tamara, Mittal, Anubhav, Chan, Ting Ting, Lo, Vincent Wing‐ho, Liang, Hui, Wang, Cong, Huang, Wei, Jin, Tao, Wu, Yongzi, Xia, Qing, Georgio, Nikolaou, Koronakis, Nikolaos, Davidsen, Line, Hamed, Emad, Mohamed, Salem, Demetrashvili, Zaza, Tvaladze, Ana, Kachakhidze, Irakli, Zurabashvili, Tea, Ioannidis, Orestis, Kapiris, Stylianos, Mavrodimitraki, Eleni, Sotiropoulou, Maria, Machairas, Nikolaos, Schizas, Dimitrios, Syllaios, Athanasios, Vailas, Michail, Chlorakis, Georgios, Kalaitzakis, Evangelos, Tsafaridou, Maria, Mulita, Francesk, Verras, Georgios‐Ioannis, Gupta, Amit, Rajput, Deepak, Sharma, Oshin, Goud, Rajesh, Unnisa, Misbah, Bains, Lovenish, Singh, Nishu, Dhar, Jahnvi, Abdelmoeti, Mahmoud, Súilleabháin, Criostóir Ó, O'Connell, Robert, Calabro, Marcello, La Terra, Antonio, Muretore, Andrea, Contul, Riccardo Brachet, Diotallevi, Margherita, Mascaro, Annamaria, Millo, Paolo, Biondo, Santino Antonio, Mazzeo, Carmelo, Cucinotta, Eugenio, Fleres, Francesco, Marinak, AOUG, Brocco, Veronica, Ceresoli, Marco, Rennis, Maria, Centonze, Danilo, Distefano, Coatanza, Veroux, Massimiliano, Zerbo, Domenico, Bogoni, Selene, Biloslavo, Alan, Bianchi, Velentina, Candelli, Marcello, Franceschi, Francesco, Gasbarrini, Antonio, Nista, Enrico, Sganga, Gabriele, Tropeano, Giuseppe, Policlinico, Fondazione, Altieri, Caterina, Dinuzzi, Vincenza, Marconi, Matteo, Rivolta, Umberto, Dameno, Vitale Roberto, Papa, Mario V., Balla, Andrea, Lepiane, Pasquale, Saraceno, Federica, Aiolfi, Alberto, Bona, Davide, Sozzi, Andrea, Cianci, Pasquale, Varesano, Marco, Conversano, Ivana, Abete, Roberta, D'Avino, Raffaele, Marra, Ester, Marte, Gianpaolo, Tammaro, Pasquale, Gobatti, Davide, Marmaggi, Serena, Palmieri, Francesco, Sampietro, Roberto, Manca, Roberto, Pilla, Federica, Piras, Enrico, Pignata, Giusto, Canfora, Ilaria, Andreuccetti, Jacopo, D'Alessio, Rossella, Armellin, Claudia, Grossi, Ugo, Massani, Marco, Pontin, Alessandro, Stecca, Tommaso, Pilia, Tiaizna, Pisanu, Adolfo, Podda, Mauro, Giuffrida, Mario, Perrone, Gennaro, Guadagni, Simone, Morelli, Luca, Frontali, Alice, Basurto, Francesca, D'Ugo, Stefano, Manoochehri, Farshad, Spampinato, Marcello, Apadula, Laura, Preatoni, Paoletta, Sartarelli, Lodovico, Al‐Jaiuossi, Osama, Ernisova, Mairam, Sopuev, Andrey, Sua, Bruce, Farfus, Anthony, Teo, Keith, Smith, Brittany, Ratnayake, Bathiya, Buchanan, Jayvee, Clark, Elinor, Connor, Saxon, Hore, Todd, Attari, Salman, Kadir, Bushra, Memon, Sadik, Abbas, Zaigham, Quadeer, Muhammad Ali, Altaf, Abeer, Ameet, Pooja, Devi, Jalpa, Seerani, Nandlal, Afzal, Ameer, Akbar, Ali, Asghar, Mohammad Sohail, Sa, Tiago, Barreira, Ana Lucia, Carvalho, Numo, Cismasiu, Brigitta, Henriques, Susana, Luiz, Francisco Vara, Draghici, Andreea, Grigorean, Valentin, Porojan, Vlad, Stoian, Alexandru‐Rares, Teaca, Lucia, Arbutina, Dragana, Cuk, Vladica, Kovacevic, Bojan, Mandic, Luka, Bonney, Glenn, Gao, Yujia, Pang, Ning Qi, Bellil, Abdalla, Devar, John, Khan, Zafar, Khumalo, Vusi, Smith, Martin, Estevez‐Fernandez, Sergio, Mosquera, Beatriz Romero, Rodriguez, Sergio, Garcia‐Rayado, Guillermo, Piñerua‐Gonsalvez, Jean Felix, Ruiz Rebollo, M Lourdes, Olmos, Jose M., Tejedor‐Tejada, Javier, Diez‐Alonso, Manuel, Matias‐Garcia, Belen, Moreno, Fernando Mendoza, Vera‐Mansilla, Cristina, Roses, Helena Salvador, Gómez, Diego Vázquez, Oballe, Juan Rodriguez, Jayarajah, Umesh, Nandasena, Malith, Pathirana, Aloka, Galal‐Eldin, Sami, Hajibandeh, Shahab, Hamid, Hytham, Colak, Elif, Sydorchuk, Larysa, Knut, Ruslan, Voronyuk, Ksenia, Chooklin, Serge, Baryskyi, Vitalii, Sydorchuk, Ruslan, Mukherjee, Samrat, Patel, Maitreyi, Akhtar, Amina, Asarbakhsh, Miriam, Nolan, Frances, Schuijtvlot, Nicholaas, Prem, Sandhya, Thrikandiyur, Anuradha, Morris, Millicent, Mroczek, Thomas, Sgourakis, George, Sultana, Asma, Varley, Rebecca, Groot‐Wassink, Thomas, Labinoti, Roland, Packham, Brett, Seebah, Keving, Allen, Sophie, Mokhtassi, Shiva, Belgaumkar, Ajay, De'Ath, Henry, Cook, Amy, Delaney, Christopher, Johnson, Roisin, Azibaodinami, Becky Olali, Sartini, Ashley, Stanfield, Mea, Tomasi, Ivan, Kanakala, Venkat, Mbarushimana, Simon, McKeever, Mark, Batilli, Mamata, Bhatta, Gakul, Rai, Subash, Bond‐smith, Giles, Elserafy, Amr, Shams, Mohamed, Al Saoudi, Tareq, Bhardwaj, Neil, Hussain, Wajith, Lancellotti, Francesco, Montagnini, Greta, Cairns, George, Hollyman, Marianne, Rakin, Asef, Shahid, Mishal, Barbour, Fraser, Hawkyard, Jake, McTeer, Matthew, Pandanaboyana, Sanjay, Taylor, Ellie, Kuzman, Matta, Dyer, Sarah, Hopkins, James, Pournaras, Dimitri, Sudlow, Alexis, Kumar, SK, Aujayeb, Avinash, Leo, Alex, Senra, Fatima Lorenzana, Watfah, Josef, Barrie, Jenifer, Brown, Chris, Gomez, Dhanny, Aroori, Somaiah, Ciprani, Debora, Karmarkar, Rahi, Almomani, Eyas, Roberts, Keith, Fale, Madeleine, Gupta, Ajay, Marsden, Max, Seet, Chris, Soni, Lakshya, Hamdan, Mohammed, Sadera, Rohan, Sud, Vikas, Chinnah, Edith, Di Mauro, Davide, Manzelli, Antonio, Orabi, Amira, Presa, Roberto, Reece‐Smith, Alex, Wajed, Shahjehan, Fingret, Jacob, Shah, Nehal, Jatania, Jignesh, Krishna, Arun, Berry, David, Kitsikosta, Loukiani, Helliwell, Jack, Huntley, Benjamin, Pine, James, Yau, Jih‐Dar, Lee, Shiela, Mahawar, Kamal, Shetty, Neehar, Britton, Emily, Shaw, Alice, Laarhoven, Stijn, Gahunia, Sukhpreet, Ortega, Miguel Gargia, Lee, Adam, Ng, Cho Ee, El Kafsi, Jihene, Mason, John, Vithlani, Gauri, Benhmida, Rami, Gunell, James, Parmar, Chetan, Dorkeh, Da‐Costa, Elnagar, Mohamed, Lee, Jih Ian, Nessa, Ashrafun, Yeap, Zhu Hui, Hemadasa, Niroshini, Javed, Saria, Sami, Sharuk, Damaskos, Dimitrios, Healey, Andrew, Soupashi, Maria, Triantafyllou, Tania, Coats, Maria, Douglass, Benjamin, Hendry, Brid, Hussain, Yasmin, Javid, Zhara, Mantyla, Mia, Rajkumar, Khaman, Chin, Carven, Hajibandeh, Shahab, Kumar, Nagappan, Gerogiannis, Ioannis, Kapsampelis, Panagiotis, Gerge, Farid, Anderson, Gulsum, Dinh, Vu, Phillips, Anna, Yadav, Dhiraj, and Pandanaboyana, Sanjay

Abstract

Since there is no current international consensus on the optimal approach for pain management in acute pancreatitis (AP), analgesic practices may vary across different healthcare settings. This study explored global disparities in analgesic use, in particular opioids, during admission and at discharge in hospitalised AP patients. This was a post hoc analysis of the prospective PAINAP database, which included all admissions for AP between April and June 2022 with a 1‐month follow‐up. Demographic details, analgesic use, and clinical outcomes were recorded during admission and at discharge. Odds ratios (ORs) for opioid use during admission and at discharge were identified using multivariable regression analyses. Amongst the 1864 patients (52% males, median age 56 (interquartile range, 41–71)) across three different continents, simple analgesics were predominantly used as the primary analgesic (70%). Opioid use during admission was lowest in European centres (67%). Admission in Asian (OR, 2.53 (95% confidence interval (CI), 1.59–4.04), p< 0.001), and Australian (OR, 5.81 (95% CI, 3.19–10.56), p< 0.001) centres was associated with opioid administration during admission compared with European centres. Increased pain severity, longer pre‐admission pain duration, organ failure, and longer length of admission increased opioid use during admission. At discharge, Asian (OR, 2.01 (95% CI, 1.40–2.88), p< 0.001) and Australian (OR, 1.91 (95% CI, 1.28–2.85), p= 0.002) centres were associated with opioid prescription compared with European centres. Increased pain severity, longer pre‐admission pain duration, acute necrotic collections, and walled‐off necrosis also increased the likelihood of opioid prescription at discharge. There are substantial intercontinental differences in opioid use for AP pain. Accordingly, there is a need for international guidelines on pain management in AP.

Published
2024
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2. Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

Author

Rottoli, Matteo, Gori, Alice, Pellino, Gianluca, Flacco, Maria Elena, Martellucci, Cecilia, Spinelli, Antonino, Poggioli, Gilberto, Romano, Angela, Belvedere, Angela, Lanci Lanci, Antonio, Parlanti, Daniele, Vago, Gabriele, Pezzuto, Paola, Canavese, Anna, Dajti, Gerti, Cardelli, Stefano, Catalioto, Caterina, Russo, Iris S, Violante, Tommaso, Morezzi, Daniele, Maurino, Ludovica, Filippone, Eleonora, Cuicchi, Dajana, Bernante, Paolo, Jovine, Elio, Lombardi, Raffaele, Masetti, Michele, Cipressi, Chiara, Offi, Maria F, Larotonda, Cristina, Puglisi, Silvana B, Barbosa, Augusto, Vaiana, Roberto, Bianchi, Paolo M, Tonti, Carlo, Codignola, Claudio, Zorcolo, Luigi, Restivo, Angelo, Deidda, Simona, Marchetti, Marcello E, Ippolito, Luca, Spolverato, Gaya, Pucciarelli, Salvatore, Marchegiani, Francesco, Ghio, Giacomo, Zagolin, Gaya, Glavas, Dajana, Tomassi, Monica, Rosati, Riccardo, Elmore, Ugo, Gozzini, Lorenzo, Calef, Riccardo, Puccetti, Francesco, Cossu, Andrea, Vignali, Andrea, Morino, Mario, Allaix, Marco E, Cannata, Gaspare, Lombardi, Erica, Ammirati, Carlo A, Piceni, Chiara, Buccianti, Piero, Balestri, Riccardo, Puccini, Marco, Pezzati, Daniele, d'Ischia, Roberto, Asta, Vito F, Sargenti, Benedetta, Taddei, Giacomo, Bonari, Federica, Boni, Giulia, Ferrero, Alessandro, Mineccia, Michela, Gonella, Federica, Palisi, Marco, Danese, Francesco, Cherubini, Valeria, Perotti, Serena, Carvello, Michele, Carbone, Fabio, Luberto, Antonio, Calafiore, Eleonora, De Lucia, Francesca, Sacchi, Matteo, Sasia, Diego, Giuffrida, Maria C, Ballauri, Edoardo, Cardile, Mathieu, Armentano, Serena, Beltrami, Elsa, Preve, Gabriele, Vercellone, Barbara, Mozzon, Marta, Folliero, Cristina, Lirusso, Chiara, Vecchiato, Massimo, Ziccarelli, Antonio, Gattesco, Davide, Moretti, Luisa, Crestale, Sara, Banchini, Filippo, Capelli, Patrizio, Romboli, Andrea, Palmieri, Gerardo, Conti, Luigi, Rizzi, Nicholas, Bonfili, Deborah, de Manzini, Nicolò, Germani, Paola, Osenda, Edoardo, Cortinovis, Sara, Giunta, Carlotta, Fracon, Stefano, Abdallah, Hussein, Bogoni, Selene, Portolani, Nazario, Nascimbeni, Riccardo, Molfino, Sarah, Tiberio, Guido A M, Garosio, Ilenia, Lamperti, Giulia, Rigosa, Diego, Ercolani, Giorgio, Solaini, Leonardo, Cavaliere, Davide, Avanzolini, Andrea, D'Acapito, Fabrizio, Chiarella, Leonardo L, Di Pietrantonio, Daniela, Annunziata, Domenico, Piccolo, Roberta, Sorrentino, Mario, Pansini, Mauro, Cojutti, Alessandro, Graziano, Michele, Callegari, Francesco, Balzarotti, Laura, Dameno, Vitale R, Cattaneo, Antonio, Santolamazza, Giuliano, Altieri, Caterina, Magarini, Riccardo, Pietrabissa, Andrea, Dominioni, Tommaso, Pugliese, Luigi, Peri, Andrea, Botti, Marta, Salvetti, Francesco, Cassinotti, Elisa, Baldari, Ludovica, Boni, Luigi, Messina, Valentina, D'Abrosca, Vera, Cianci, Pasquale, Tumolo, Rocco, Gattulli, Domenico, Restini, Enrico, Minafra, Marina, Sederino, Maria G, Bottalico, Bernardino, Pilati, Pierluigi, Franzato, Boris, Mattara, Genny, De Simoni, Ottavia, Barina, Andrea, Tonello, Marco, Muratore, Andrea, Calabrò, Marcello, Federico Pipitone, Nicoletta S, Cuzzola, Bruno, Herranz van Nood, Elena, Passuello, Nicola, Frasson, Alvise, Mammano, Enzo, Faccio, Luca, Vittadello, Fabrizio, Bressan, Alice, Sarzo, Giacomo, Tamini, Nicolò, Oldani, Massimo, Cigagna, Luca, Carissimi, Francesca, De Carlo, Giulia, Baccalini, Edoardo, Nespoli, Luca, Giordano, Alessio, Cantafio, Stefano, Grifoni, Lucrezia, Matani, Davide, Livi, Serena, Delogu, Daniele, Scognamillo, Fabrizio, Marrosu, Antonio, Guerrini, Luca, Ugolini, Giampaolo, Ghignone, Federico, Frascaroli, Giacomo, Albertini, Nicola, Zattoni, Davide, Taffurelli, Giovanni, Montroni, Isacco, Colombo, Francesco, Danelli, Piergiorgio, Bondurri, Andrea, Maffioli, Anna, Bonomi, Alessandro, Pezzoli, Isabella, Cammarata, Francesco, Goletti, Orlando, Molteni, Mattia, Assisi, Alberto, Quartierini, Giorgio, Da Lio, Corrado, Verdi, Daunia, Mondi, Isabella, Peluso, Claudia, Macchi, Lorenzo, Tanzanu, Marta, Zanzi, Federico, Pellegrini, Sara, Andreuccetti, Jacopo, D'Alessio, Rossella, Pignata, Giusto, De Capua, Michele, Canfora, Ilaria, Ottaviani, Luca, Lepiane, Pasquale, Balla, Andrea, De Carlo, Antonio, Saraceno, Federica, Scaramuzzo, Rosa, Guida, Anna, Aguzzi, Daniele, Bellora, Paolo, Gentilli, Sergio, Monni, Manuela, Nikaj, Herald, Cillara, Nicola, Cannavera, Alessandro, Deserra, Antonello, Margiani, Carla, Cabula, Roberta, Dettori, Manuela, Gramignano, Giulia, Lezoche, Giovanni, Ortenzi, Monica, Orlandoni, Elena S, Curzi, Federica, Vitali, Francesca, Capomagi, Perla, Palmieri, Miriam, Giuffrida, Mario, Del Rio, Paolo, Bonati, Elena, Loderer, Tommaso, Cozzani, Federico, Rossini, Matteo, Agnesi, Stefano, Capolupo, Gabriella T, Caricato, Marco, Carannante, Filippo, Mascianà, Gianluca, Marrelli, Martina, Miacci, Valentina, Lauricella, Sara, Tonini, Valeria, Cervellera, Maurizio, Pisconti, Salvatore, Lozito, Concetta, Shahu, Juliana, Mongelli, Claudia, Morelli, Giulia, Sartarelli, Lodovico, Sica, Giuseppe S, Siragusa, Leandro, Bagaglini, Giulia, Sensi, Bruno, Guida, Andrea M, Franceschilli, Marzia, Vinci, Danilo, Taddei, Antonio, Risaliti, Matteo, Bartolini, Ilenia, Ringressi, Maria N, Tirloni, Luca, Laface, Letizia, Abate, Emmanuele, Casati, Massimiliano, Gobbi, Pietro, Opocher, Enrico, Mariani, Nicolò M, Pisani Ceretti, Andrea, Giovenzana, Marco, Giuliani, Beatrice, Sironi, Martina, Grossi, Ugo, Zanus, Giacomo, Aniello Santoro, Giulio, Brizzolari, Marco, De Leo, Eugenio, Novello, Simone, Aquilino, Krizia, Milardi, Francesco, Olmi, Stefano, Uccelli, Matteo, Bonaldi, Marta, Cesana, Giovanni C, Bindi, Marco, Galleano, Raffaele, Langone, Antonio, Botto, Massimiliano, Franceschi, Angelo, Gambino, Elena, Ronconi, Maurizio, Casiraghi, Silvia, Casole, Giovanni, Ciulla, Salvatore L, Terrosu, Giovanni, Calandra, Sergio, Scarpa, Edoardo, Cherchi, Vittorio, Calini, Giacomo, Martinuzzo, Lisa, Clocchiatti, Lucrezia, Muschitiello, Davide, Romanzi, Andrea, Vignati, Barbara, Vannelli, Alberto, Scolaro, Roberta, Milanesi, Maria, Rossi, Fabrizio, Canonico, Giuseppe, Anastasi, Alessandro, Nelli, Tommaso, Barlettai, Marco, Fratarcangeli, Riccardo, Di Martino, Carmela, Damigella, Andrea, Adinolfi, Elvira, Birindelli, Arianna, Taglietti, Lucio, Dester, Sara E, Fleres, Francesco, Cucinotta, Eugenio, Viscosi, Francesca, Biondo Santino, Antonio, Badessi, Giorgio, Catarsini, Nivia, Mazzeo, Carmelo, Rega, Daniela, Delrio, Paolo, Cervone, Carmela, Aversano, Alessia, De Franciscis, Silvia, Di Marzo, Massimiliano, Marra, Bruno, Pace, Ugo, Amato, Antonio, Batistotti, Paola, Mina, Elisa, Serventi, Alberto, Lapolla, Pierfrancesco, Mingoli, Andrea, Sapienza, Paolo, Brachini, Gioia, Cirillo, Bruno, Fiori, Enrico, Crocetti, Daniele, Clementi, Ilaria, Martines, Gennaro, Picciariello, Arcangelo, Tomasicchio, Giovanni, Dibra, Rigers, Trigiante, Giuseppe, Rinaldi, Marcella, Lantone, Giuliano, Porcu, Alberto, Perra, Teresa, Scanu, Antonio M, Feo, Claudio F, Fancellu, Alessandro, Cossu, Maria L, Ginesu, Giorgio C, Patriti, Alberto, Coletta, Diego, Petrelli, Filippo, Greco, Paola A, Spadoni, Claudia, Cassiani, Giovanna, Bianchini, Federica, Arganini, Marco, Bianchini, Matteo, Perotti, Bruno, Palmeri, Matteo, Scabini, Stefano, Deiana, Selene, Carganico, Giacomo, Pertile, Davide, Soriero, Domenico, Fioravanti, Emanuela, Sperotto, Beatrice, Nardo, Bruno, Paglione, Daniele, Crocco, Veronica, Doni, Marco, Osso, Mariasara, Perri, Roberto, Sampietro, Gianluca M, Corbellini, Carlo, Lorusso, Leonardo, Manzo, Carlo A, Cigognini, Maria, Baldi, Caterina, Palomba, Giuseppe, Aprea, Giovanni, Capuano, Marianna, Basile, Raffaele, Tutino, Roberta, Massani, Marco, Marinelli, Laura, Canitano, Nicola, Pilia, Tiziana, Podda, Mauro, Pisanu, Adolfo, Murzi, Valentina, Incani, Silvia, Frongia, Federica, Esposito, Giuseppe, Luglio, Gaetano, Tropeano, Francesca P, Pagano, Gianluca, Spina, Eduardo, De Simone, Giuseppe, Cricrì, Michele, Catena, Fausto, Vallicelli, Carlo, Zanini, Nicola, Ronconi, Diana, Favi, Francesco, Mazzucchelli, Carlo, Convertini, Girolamo, Vincenti, Leonardo, Andriola, Valeria, Bizzoca, Cinzia, Feo, Carlo V, Fabbri, Nicolò, Fazzin, Marta, Pesce, Antonio, Gennari, Silvia, Torchiaro, Marco, Severi, Silvia, Frontali, Alice, Bracchetti, Greta, Granieri, Stefano, Cotsoglou, Christian, Carlini, Massimo, Lisi, Giorgio, Spoletini, Domenico, Mastrangeli, Maria R, Campanelli, Michela, Manigrasso, Michele, Milone, Marco, De Palma, Giovanni D, Vertaldi, Sara, Chini, Alessia, Maione, Francesco, Marello, Alessandra, Selvaggi, Francesco, Sciaudone, Guido, Selvaggi, Lucio, Menegon Tasselli, Francesco, Fuschillo, Giacomo, Oddis, Lidia, Grande, Simona, Grande, Michele, Ascanelli, Simona, Chimisso, Laura, Aisoni, Filippo, Rossin, Eleonora, Pepe, Francesco, Marchetti, Francesco, Picardi, Biagio, Rossi, Stefano, Rossi Del Monte, Simone, Picarelli, Matteo, Muttillo, Irnerio A, Ratto, Carlo, Marra, Angelo A, Parello, Angelo, Litta, Francesco, Campennì, Paola, De Simone, Veronica, Pata, Francesco, Riboni, Cristiana, Rausa, Emanuele, Celentano, Valerio, Institut Català de la Salut, [Rottoli M, Gori A, Pellino G] Surgery of the Alimentary Tract, IRCCS Azienda Ospedaliero–Universitaria di Bologna, Bologna, Italy. Surgery of the Alimentary Tract, IRCCS Azienda Ospedaliero–Universitaria di Bologna, Bologna, Italy. [Pellino G] Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy. Unitat de Cirurgia de Còlon i Recte, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Flacco ME, Martellucci C] Department of Environmental and Preventive Sciences, University of Ferrara, Ferrara, Italy. [Spinelli A] Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy. Colorectal Surgery, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy, Vall d'Hebron Barcelona Hospital Campus, Rottoli, Matteo, Gori, Alice, Pellino, Gianluca, Flacco, Maria Elena, Martellucci, Cecilia, Spinelli, Antonino, Poggioli, Gilberto, Romano, Angela, Belvedere, Angela, Lanci Lanci, Antonio, Parlanti, Daniele, Vago, Gabriele, Pezzuto, Paola, Canavese, Anna, Dajti, Gerti, Cardelli, Stefano, Catalioto, Caterina, Russo, Iris S, Violante, Tommaso, Morezzi, Daniele, Maurino, Ludovica, Filippone, Eleonora, Cuicchi, Dajana, Bernante, Paolo, Jovine, Elio, Lombardi, Raffaele, Masetti, Michele, Cipressi, Chiara, Offi, Maria F, Larotonda, Cristina, Puglisi, Silvana B, Barbosa, Augusto, Vaiana, Roberto, Bianchi, Paolo M, Tonti, Carlo, Codignola, Claudio, Zorcolo, Luigi, Restivo, Angelo, Deidda, Simona, Marchetti, Marcello E, Ippolito, Luca, Spolverato, Gaya, Pucciarelli, Salvatore, Marchegiani, Francesco, Ghio, Giacomo, Zagolin, Gaya, Glavas, Dajana, Tomassi, Monica, Rosati, Riccardo, Elmore, Ugo, Gozzini, Lorenzo, Calef, Riccardo, Puccetti, Francesco, Cossu, Andrea, Vignali, Andrea, Morino, Mario, Allaix, Marco E, Cannata, Gaspare, Lombardi, Erica, Ammirati, Carlo A, Piceni, Chiara, Buccianti, Piero, Balestri, Riccardo, Puccini, Marco, Pezzati, Daniele, d'Ischia, Roberto, Asta, Vito F, Sargenti, Benedetta, Taddei, Giacomo, Bonari, Federica, Boni, Giulia, Ferrero, Alessandro, Mineccia, Michela, Gonella, Federica, Palisi, Marco, Danese, Francesco, Cherubini, Valeria, Perotti, Serena, Carvello, Michele, Carbone, Fabio, Luberto, Antonio, Calafiore, Eleonora, De Lucia, Francesca, Sacchi, Matteo, Sasia, Diego, Giuffrida, Maria C, Ballauri, Edoardo, Cardile, Mathieu, Armentano, Serena, Beltrami, Elsa, Preve, Gabriele, Vercellone, Barbara, Mozzon, Marta, Folliero, Cristina, Lirusso, Chiara, Vecchiato, Massimo, Ziccarelli, Antonio, Gattesco, Davide, Moretti, Luisa, Crestale, Sara, Banchini, Filippo, Capelli, Patrizio, Romboli, Andrea, Palmieri, Gerardo, Conti, Luigi, Rizzi, Nichola, Bonfili, Deborah, de Manzini, Nicolò, Germani, Paola, Osenda, Edoardo, Cortinovis, Sara, Giunta, Carlotta, Fracon, Stefano, Abdallah, Hussein, Bogoni, Selene, Portolani, Nazario, Nascimbeni, Riccardo, Molfino, Sarah, Tiberio, Guido A M, Garosio, Ilenia, Lamperti, Giulia, Rigosa, Diego, Ercolani, Giorgio, Solaini, Leonardo, Cavaliere, Davide, Avanzolini, Andrea, D'Acapito, Fabrizio, Chiarella, Leonardo L, Di Pietrantonio, Daniela, Annunziata, Domenico, Piccolo, Roberta, Sorrentino, Mario, Pansini, Mauro, Cojutti, Alessandro, Graziano, Michele, Callegari, Francesco, Balzarotti, Laura, Dameno, Vitale R, Cattaneo, Antonio, Santolamazza, Giuliano, Altieri, Caterina, Magarini, Riccardo, Pietrabissa, Andrea, Dominioni, Tommaso, Pugliese, Luigi, Peri, Andrea, Botti, Marta, Salvetti, Francesco, Cassinotti, Elisa, Baldari, Ludovica, Boni, Luigi, Messina, Valentina, D'Abrosca, Vera, Cianci, Pasquale, Tumolo, Rocco, Gattulli, Domenico, Restini, Enrico, Minafra, Marina, Sederino, Maria G, Bottalico, Bernardino, Pilati, Pierluigi, Franzato, Bori, Mattara, Genny, De Simoni, Ottavia, Barina, Andrea, Tonello, Marco, Muratore, Andrea, Calabrò, Marcello, Federico Pipitone, Nicoletta S, Cuzzola, Bruno, Herranz van Nood, Elena, Passuello, Nicola, Frasson, Alvise, Mammano, Enzo, Faccio, Luca, Vittadello, Fabrizio, Bressan, Alice, Sarzo, Giacomo, Tamini, Nicolò, Oldani, Massimo, Cigagna, Luca, Carissimi, Francesca, De Carlo, Giulia, Baccalini, Edoardo, Nespoli, Luca, Giordano, Alessio, Cantafio, Stefano, Grifoni, Lucrezia, Matani, Davide, Livi, Serena, Delogu, Daniele, Scognamillo, Fabrizio, Marrosu, Antonio, Guerrini, Luca, Ugolini, Giampaolo, Ghignone, Federico, Frascaroli, Giacomo, Albertini, Nicola, Zattoni, Davide, Taffurelli, Giovanni, Montroni, Isacco, Colombo, Francesco, Danelli, Piergiorgio, Bondurri, Andrea, Maffioli, Anna, Bonomi, Alessandro, Pezzoli, Isabella, Cammarata, Francesco, Goletti, Orlando, Molteni, Mattia, Assisi, Alberto, Quartierini, Giorgio, Da Lio, Corrado, Verdi, Daunia, Mondi, Isabella, Peluso, Claudia, Macchi, Lorenzo, Tanzanu, Marta, Zanzi, Federico, Pellegrini, Sara, Andreuccetti, Jacopo, D'Alessio, Rossella, Pignata, Giusto, De Capua, Michele, Canfora, Ilaria, Ottaviani, Luca, Lepiane, Pasquale, Balla, Andrea, De Carlo, Antonio, Saraceno, Federica, Scaramuzzo, Rosa, Guida, Anna, Aguzzi, Daniele, Bellora, Paolo, Gentilli, Sergio, Monni, Manuela, Nikaj, Herald, Cillara, Nicola, Cannavera, Alessandro, Deserra, Antonello, Margiani, Carla, Cabula, Roberta, Dettori, Manuela, Gramignano, Giulia, Lezoche, Giovanni, Ortenzi, Monica, Orlandoni, Elena S, Curzi, Federica, Vitali, Francesca, Capomagi, Perla, Palmieri, Miriam, Giuffrida, Mario, Del Rio, Paolo, Bonati, Elena, Loderer, Tommaso, Cozzani, Federico, Rossini, Matteo, Agnesi, Stefano, Capolupo, Gabriella T, Caricato, Marco, Carannante, Filippo, Mascianà, Gianluca, Marrelli, Martina, Miacci, Valentina, Lauricella, Sara, Tonini, Valeria, Cervellera, Maurizio, Pisconti, Salvatore, Lozito, Concetta, Shahu, Juliana, Mongelli, Claudia, Morelli, Giulia, Sartarelli, Lodovico, Sica, Giuseppe S, Siragusa, Leandro, Bagaglini, Giulia, Sensi, Bruno, Guida, Andrea M, Franceschilli, Marzia, Vinci, Danilo, Taddei, Antonio, Risaliti, Matteo, Bartolini, Ilenia, Ringressi, Maria N, Tirloni, Luca, Laface, Letizia, Abate, Emmanuele, Casati, Massimiliano, Gobbi, Pietro, Opocher, Enrico, Mariani, Nicolò M, Pisani Ceretti, Andrea, Giovenzana, Marco, Giuliani, Beatrice, Sironi, Martina, Grossi, Ugo, Zanus, Giacomo, Aniello Santoro, Giulio, Brizzolari, Marco, De Leo, Eugenio, Novello, Simone, Aquilino, Krizia, Milardi, Francesco, Olmi, Stefano, Uccelli, Matteo, Bonaldi, Marta, Cesana, Giovanni C, Bindi, Marco, Galleano, Raffaele, Langone, Antonio, Botto, Massimiliano, Franceschi, Angelo, Gambino, Elena, Ronconi, Maurizio, Casiraghi, Silvia, Casole, Giovanni, Ciulla, Salvatore L, Terrosu, Giovanni, Calandra, Sergio, Scarpa, Edoardo, Cherchi, Vittorio, Calini, Giacomo, Martinuzzo, Lisa, Clocchiatti, Lucrezia, Muschitiello, Davide, Romanzi, Andrea, Vignati, Barbara, Vannelli, Alberto, Scolaro, Roberta, Milanesi, Maria, Rossi, Fabrizio, Canonico, Giuseppe, Anastasi, Alessandro, Nelli, Tommaso, Barlettai, Marco, Fratarcangeli, Riccardo, Di Martino, Carmela, Damigella, Andrea, Adinolfi, Elvira, Birindelli, Arianna, Taglietti, Lucio, Dester, Sara E, Fleres, Francesco, Cucinotta, Eugenio, Viscosi, Francesca, Biondo Santino, Antonio, Badessi, Giorgio, Catarsini, Nivia, Mazzeo, Carmelo, Rega, Daniela, Delrio, Paolo, Cervone, Carmela, Aversano, Alessia, De Franciscis, Silvia, Di Marzo, Massimiliano, Marra, Bruno, Pace, Ugo, Amato, Antonio, Batistotti, Paola, Mina, Elisa, Serventi, Alberto, Lapolla, Pierfrancesco, Mingoli, Andrea, Sapienza, Paolo, Brachini, Gioia, Cirillo, Bruno, Fiori, Enrico, Crocetti, Daniele, Clementi, Ilaria, Martines, Gennaro, Picciariello, Arcangelo, Tomasicchio, Giovanni, Dibra, Riger, Trigiante, Giuseppe, Rinaldi, Marcella, Lantone, Giuliano, Porcu, Alberto, Perra, Teresa, Scanu, Antonio M, Feo, Claudio F, Fancellu, Alessandro, Cossu, Maria L, Ginesu, Giorgio C, Patriti, Alberto, Coletta, Diego, Petrelli, Filippo, Greco, Paola A, Spadoni, Claudia, Cassiani, Giovanna, Bianchini, Federica, Arganini, Marco, Bianchini, Matteo, Perotti, Bruno, Palmeri, Matteo, Scabini, Stefano, Deiana, Selene, Carganico, Giacomo, Pertile, Davide, Soriero, Domenico, Fioravanti, Emanuela, Sperotto, Beatrice, Nardo, Bruno, Paglione, Daniele, Crocco, Veronica, Doni, Marco, Osso, Mariasara, Perri, Roberto, Sampietro, Gianluca M, Corbellini, Carlo, Lorusso, Leonardo, Manzo, Carlo A, Cigognini, Maria, Baldi, Caterina, Palomba, Giuseppe, Aprea, Giovanni, Capuano, Marianna, Basile, Raffaele, Tutino, Roberta, Massani, Marco, Marinelli, Laura, Canitano, Nicola, Pilia, Tiziana, Podda, Mauro, Pisanu, Adolfo, Murzi, Valentina, Incani, Silvia, Frongia, Federica, Esposito, Giuseppe, Luglio, Gaetano, Tropeano, Francesca P, Pagano, Gianluca, Spina, Eduardo, De Simone, Giuseppe, Cricrì, Michele, Catena, Fausto, Vallicelli, Carlo, Zanini, Nicola, Ronconi, Diana, Favi, Francesco, Mazzucchelli, Carlo, Convertini, Girolamo, Vincenti, Leonardo, Andriola, Valeria, Bizzoca, Cinzia, Feo, Carlo V, Fabbri, Nicolò, Fazzin, Marta, Pesce, Antonio, Gennari, Silvia, Torchiaro, Marco, Severi, Silvia, Frontali, Alice, Bracchetti, Greta, Granieri, Stefano, Cotsoglou, Christian, Carlini, Massimo, Lisi, Giorgio, Spoletini, Domenico, Mastrangeli, Maria R, Campanelli, Michela, Manigrasso, Michele, Milone, Marco, De Palma, Giovanni D, Vertaldi, Sara, Chini, Alessia, Maione, Francesco, Marello, Alessandra, Selvaggi, Francesco, Sciaudone, Guido, Selvaggi, Lucio, Menegon Tasselli, Francesco, Fuschillo, Giacomo, Oddis, Lidia, Grande, Simona, Grande, Michele, Ascanelli, Simona, Chimisso, Laura, Aisoni, Filippo, Rossin, Eleonora, Pepe, Francesco, Marchetti, Francesco, Picardi, Biagio, Rossi, Stefano, Rossi Del Monte, Simone, Picarelli, Matteo, Muttillo, Irnerio A, Ratto, Carlo, Marra, Angelo A, Parello, Angelo, Litta, Francesco, Campennì, Paola, De Simone, Veronica, Pata, Francesco, Riboni, Cristiana, Rausa, Emanuele, and Celentano, Valerio

Subjects
Adult, Male, Settore MED/18 - CHIRURGIA GENERALE, Otros calificadores::/diagnóstico [Otros calificadores], Hospitals, Community, colorectal cancer, Community, advanced stage, COVID-19 (Malaltia), Cohort Studies, Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Gastrointestinal Neoplasms::Intestinal Neoplasms::Colorectal Neoplasms [DISEASES], Retrospective Studie, Other subheadings::/diagnosis [Other subheadings], virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus [ENFERMEDADES], Humans, Pandemics, Aged, Retrospective Studies, Pandemic, SARS-CoV-2, COVID-19, Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections [DISEASES], General Medicine, neoplasias::neoplasias por localización::neoplasias del sistema digestivo::neoplasias gastrointestinales::neoplasias intestinales::neoplasias colorrectales [ENFERMEDADES], Hospitals, Recte - Càncer - Diagnòstic, Settore MED/18, Italy, Còlon - Càncer - Diagnòstic, Cohort Studie, Colorectal Neoplasms, Human
Abstract

ImportanceDelays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis.ObjectiveTo evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer.Design, Setting, and ParticipantsThis retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery.ExposuresAny type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections.Main Outcomes and MeasuresThe primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable.ResultsA total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95% CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95% CI, 1.15-1.53; P P = .03).Conclusions and RelevanceThis cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients.

Published
2022

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