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Weekend admissions for upper GI bleeding result in poorer outcomes, speaker says

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SAN DIEGO — Patients with upper gastrointestinal bleeding admitted to hospitals on weekends demonstrated increased mortality, longer time to endoscopy and greater need for surgery, along with a reduced likelihood of endoscopy on admission day, a speaker said here.

“Timely intervention in patients presenting with active GI bleeds have been shown to reduce mortality,” Alisha Hinds, DO, said during the annual meeting of the American College of Gastroenterology. The “weekend effect” of delayed response suggests a potential need for system modifications.

 

Alisha Hinds

Researchers conducted a meta-analysis using fixed and random effects models with odds ratio or mean difference to assess for mortality, need for surgery, length of stay, time to endoscopy and endoscopy on admission day across 11 studies comparing weekend to weekday outcomes in patients with upper gastrointestinal bleeding (UGIB). The meta-analysis included 870,374 patients.

The study found a statistically significant increase in mortality (OR 1.13, P<.01), need for surgery (OR 2.46, P<.01) and time to endoscopy (MD 2.68, P=.04) when compared with weekday admissions, Hinds said. The study also determined weekend patients were less likely to have an endoscopy on day of admission (OR 0.72, P<.01).

The length of the hospital stay was not significantly different between weekend and weekday groups.

The study was limited by the potential for subject duplication across the 11 studies, as several studies included used the same database with different search terms, Hinds said.

“We must not overemphasize the results we have here,” she said.

Disclosure: Hinds reports no relevant financial disclosures.

For more information:

Hinds, A.M. #17: Weekday versus Weekend Admissions for Upper Gastrointestinal Bleeding: Is There a True Difference in Patient Outcomes? A Meta-analysis. Presented at: the 2013 American College of Gastroenterology Annual Scientific Meeting; Oct. 11-16, San Diego.