P55 Impact of the COVID-19 pandemic on the outcomes for the patients presenting with acute upper gastrointestinal variceal bleeding – A University hospital experience

Abdullah Abbasi; Rajeev Desai; Srisha Hebbar

doi:10.1136/gutjnl-2022-BASL.106

IntroductionAcute upper gastrointestinal variceal bleeding (UGIVB) is a severe presentation of chronic liver disease (CLD) often leading to poor patient outcomes. Coronavirus disease 2019 (COVID-19) pandemic caused significant disruption to healthcare provision. Alcohol consumption and body mass index, two important risk factors for CLD both rose during the pandemic. We undertook this retrospective audit aiming to assess the impact of the pandemic on the outcomes of the patients presenting with UGIVB to University Hospitals of North Midlands (UHNM).MethodsPre-COVID year was defined as the period between 16/03/2019 to 15/03/2020 and COVID year was defined as the period from 16/03/2020 (first lockdown in the UK) to 15/03/2021. A total of 11,975 gastroscopy reports were retrieved from the endoscopy reporting database during the study period. These reports were screened for ‘varices’, ‘Upper GI bleeding’, ‘banding’, ‘thrombin’, ’glue’. All cases of non-variceal bleeding and non-bleeding varices were excluded. T-test, chi-square test, Kaplan Meier survival estimates, Log Rank test and Cox regression tests were used.ResultsThere were 74 patients in pre-COVID year and 75 patients in COVID year with UGIVB. There was no significant difference between these two groups in the following parameters: mean age 57.4 years in pre-COVID year (95%CL 53.6,61.1) versus 56.8 (53.8, 59.8, p= 0.8) in COVID year, MELDNa score was 19.4 (17.5, 21.3) vs 18.9 (17.1, 20.7). In pre-COVID year, 52.7% patients had endoscopy performed out of hours compared to 64% in COVID year. Eleven patients (14.9%) received intensive care in pre-COVID year versus 9 (12%) in COVID year (p=0.30). One patients needed TIPS following UGIVB in pre-COVID year versus 6 in COVID year (p=0.06). In pre-COVID year, 35.1% patients died within 90 days of UGIVB compared to 20% in COVID year (p=0.31). The risk adjusted hazard of death in the COVID year was not statistically significantly different than the hazard in the pre-COVID year (HR for covid year = 0.64 [0.34, 1.22], p=0.18).Abstract P55 Figure 1Patient survival to 90 days in precovid year compared with covid yearDiscussionAlthough the overall mortality of patients presenting with UGIVB to UHNM was high, there was no significant difference in the mortality between the pre-COVID and the COVID year. This finding contrasts with the previously published data from London. Several factors may have contributed to this difference including variations in patient characteristics, availability of endoscopy services during the periods of lockdown and the variations in the overall burden of COVID pandemic on the hospitals in different parts of the country.

P55 Impact of the COVID-19 pandemic on the outcomes for the patients presenting with acute upper gastrointestinal variceal bleeding – A University hospital experience

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