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Weekend and nighttime effect on the prognosis of peptic ulcer bleeding

Authors
 Young Hoon Youn  ;  Yong Jin Park  ;  Jae Hak Kim  ;  Tae Joo Jeon  ;  Jae Hee Cho  ;  Hyojin Park 
Citation
 WORLD JOURNAL OF GASTROENTEROLOGY, Vol.18(27) : 3578-3584, 2012 
Journal Title
 WORLD JOURNAL OF GASTROENTEROLOGY 
ISSN
 1007-9327 
Issue Date
2012
MeSH
After-Hours Care* ; Chi-Square Distribution ; Emergency Service, Hospital* ; Female ; Health Services Accessibility* ; Hemostasis, Endoscopic*/adverse effects ; Hemostasis, Endoscopic*/mortality ; Hospital Mortality ; Humans ; Length of Stay ; Linear Models ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; Peptic Ulcer Hemorrhage/pathology ; Peptic Ulcer Hemorrhage/therapy* ; Recurrence ; Reoperation ; Republic of Korea ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Time Factors ; Treatment Outcome
Keywords
Early endoscopy ; Nighttime effect ; Peptic ulcer bleeding ; Rebleeding ; Weekend effect
Abstract
AIM: To evaluate whether weekend or nighttime admission affects prognosis of peptic ulcer bleeding despite early endoscopy. METHODS: Retrospective data collection from four referral centers, all of which had a formal out-of-hours emergency endoscopy service, even at weekends. A total of 388 patients with bleeding peptic ulcers who were admitted via the emergency room between January 2007 and December 2009 were enrolled. Analyzed parameters included time from patients' arrival until endoscopy, mortality, rebleeding, need for surgery and length of hospital stay. RESULTS: The weekday and weekend admission groups comprised 326 and 62 patients, respectively. There were no significant differences in baseline characteristics between the two groups, except for younger age in the weekend group. Most patients (97%) had undergone early endoscopy, which resulted in a low mortality rate regardless of point of presentation (1.8% overall vs 1.6% on the weekend). The only outcome that was worse in the weekend group was a higher rate of rebleeding (12% vs 21%, P = 0.030). However, multivariate analysis revealed nighttime admission and a high Rockall score (≥ 6) as significant independent risk factors for rebleeding, rather than weekend admission. CONCLUSION: Early endoscopy for peptic ulcer bleeding can prevent the weekend effect, and nighttime admission was identified as a novel risk factor for rebleeding, namely the nighttime effect.
Files in This Item:
T201202538.pdf Download
DOI
22826623
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Yong Jin(박용진)
Park, Hyo Jin(박효진) ORCID logo https://orcid.org/0000-0003-4814-8330
Youn, Young Hoon(윤영훈) ORCID logo https://orcid.org/0000-0002-0071-229X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/92021
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