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• W2977883383 abstract "Introduction: Upper gastrointestinal bleeding (UGIB) is a common gastrointestinal emergency with substantial morbidity, mortality and cost. The annual incidence of hospitalization for acute UGIB is approximately 100 per 100,000 individuals. There have been multiple studies showing worse outcomes in patients admitted over the weekend for various medical emergencies. However data is limited in this subset of population. The aim of this study is to evaluate the weekend effect on non variceal upper gastrointestinal hemorrhage (NVUGH). Methods: The NIS from year 2003- 2013 was queried to identify patients with NVUGH using International Classification of Diseases (ICD) ninth edition codes, which included bleeding peptic ulcer (esophageal, gastric or duodenal), gastritis, dieulafoy's lesion and angiodysplasia. Multiple endoscopy procedure codes (45.13, 45.14, 45.16, 42.23, 44.13, 42.33, 44.43, endoscopic control of ulcer bleeding 44.43) though not very specific to non-variceal hemorrhage were included to see if availability of the endoscopy had an effect on mortality. In hospital mortality, timing of endoscopy and teaching status of the hospital were analyzed. Results: A total of 2,565,337 admissions were identified with principal diagnosis of NVUGH, excluding patients less than 18 years of age. Mean age of this population set is 67 +/- 17 and 47.4 % are females. It was observed that likelihood of death is more in patients admitted over the weekend (2.5%) when compared to weekday admissions (2.1%), with significant p < 0.0001, Odds ratio (OR)1.179, 95 % Confidence Interval (CI) 1.157-1.202. A total of 1,693,138 admissions had endoscopy as principal procedure. Weekend admissions had less likelihood of early endoscopy - on day 0/1 (56.4%) when compared to weekday admissions (66.6%) with p < 0.00001, OR 0.651, CI 0.646-0.655., When compared with non-teaching hospitals (63.6%), teaching hospitals (63.2%) had a lower rate of early endoscopy with p < 0.0001, OR 0.982, CI 0.975-0.989. Teaching hospitals had a higher likelihood of deaths (2.4%) when compared to non- teaching hospitals (2.2%) with p< 0.0001, OR 1.096, CI 1.077- 1.116. Conclusion: NVUGH does show weekend effect when assessed for single cause mortality. Weekend admission also had less likelihood of early endoscopy. Teaching hospitals had lower rate of endoscopy with higher mortality. Further research will help in determining availability of early endoscopy in decreasing the length of stay, hospital charges and mortality." @default.
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• W2977883383 date "2016-10-01" @default.
• W2977883383 modified "2023-09-27" @default.
• W2977883383 title "Non-variceal Upper Gastrointestinal Hemorrhage: Hospital Status and Weekend Admissions Effect on Mortality and Early Endoscopy - National Inpatient Sample Study 2003-2012" @default.
• W2977883383 doi "https://doi.org/10.14309/00000434-201610001-00965" @default.
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