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Outcomes in lower GI bleeding comparing weekend with weekday admission.
Gastrointest Endosc. 2020 Apr 21;:
Authors: Li B, Stein DJ, Schwartz J, Lipscey M, Feuerstein JD
Abstract
BACKGROUND AND AIMS: Acute lower gastrointestinal bleeding (LGIB) is a common indication for hospitalization potentially requiring urgent intervention, which may not be readily available on weekends and off-hours. The aim of this study is to examine the association among weekend admission for LGIB and mortality, time to colonoscopy, length of stay, and hospital charges.
METHODS: The 2016 U.S. National Inpatient Sample (NIS) dataset was queried for admissions with a primary diagnosis of LGIB. Outcomes for weekend versus weekday admissions were compared using survey-adjusted Chi-square or bivariate correlation. Multivariable regression was then used to compare primary outcomes adjusting for the Elixhauser mortality score (a validated measure of comorbidities), colonoscopy, transfusion, shock, and hospital type.
RESULTS: An estimated 124,620 patients were admitted for LGIB in 2016. When comparing weekend with weekday admissions, there was no difference in unadjusted mortality (0.9% vs 1.0%, p=0.636). Colonoscopy within the first day (28.6% vs 23.0%, p<0.001) and transfusion (34.0% vs 31.5%, p<0.001) were more common with weekday admissions; no differences in colonoscopy rate (60.7% vs 60.9%, p=0.818), angiography rate (2.7% vs 2.7%, p=0.976), mean days to colonoscopy (2.0 vs 2.0, p=0.233), or length of stay (4.2 vs 4.1 days, p=0.068) were seen. There was no difference in multivariable adjusted mortality rates (OR, 1.11; 95% CI, 0.81-1.54; p=0.495) based on the above factors.
CONCLUSIONS: Early colonoscopy (within the first day) is more common for weekday admissions, but overall outcomes are not affected by weekend admission for LGIB as compared with weekday admissions.
PMID: 32330505 [PubMed - as supplied by publisher]