Patients with GI bleeding admitted on the weekend have higher ... (Calgary and lead author of the study. F...)

Patients with GI bleeding admitted on the weekend have higher death rate

Date:2/28/2009

Calgary and lead author of the study. "Future studies should explore alternative processes of care that may mediate these effects, as upper gastrointestinal bleeding represents a considerable clinical and economic burden."

The annual prevalence of upper gastrointestinal bleeding (UGIB) is approximately 170 per 100,000 people and cost is estimated at approximately $750 million. Peptic ulcer disease accounts for 50 to 70 percent of UGIB cases.

Data were extracted from the 1993-2005 U.S. Nationwide Inpatient Sample to identify patients hospitalized for UGIB due to peptic ulceration. Differences in in-hospital mortality between patients admitted on weekends and weekdays were evaluated using logistic regression models, adjusting for patient and clinical factors, including the timing of upper endoscopy.

Between 1993 and 2005, there were 237,412 admissions to 3,166 hospitals for peptic ulcer-related UGIB. Compared with patients admitted on a weekday, those admitted on the weekend had an increased risk of death (3.4 percent versus 3.0 percent), higher rates of surgical intervention (3.4 percent versus 3.1 percent), prolonged hospital stays and increased hospital charges. Although patients hospitalized on the weekend tended to be slightly sicker than patients hospitalized on a weekday (e.g., more likely to be admitted urgently and to have clotting disorders), the observed differences persisted despite adjustment for these patient and hospital-related factors.

Patients admitted on the weekend had a longer mean time to endoscopy (2.21 0.01 versus 2.06 0.01 days) and were less likely to undergo endoscopy on the day of admission (30 percent versus 34 percent). After adjusting for the timing of endoscopy, weekend admission remained an independent predictor of increased mortality.

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Contact: Alissa Cruz
media@gastro.org
301-272-1603
American Gastroenterological Association
Source:Eurekalert

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Patients with GI bleeding admitted on the weekend have higher ...(Calgary and lead author of the study. F...),Health