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Acute variceal hemorrhage in patients with liver cirrhosis: weekend versus weekday admissions

Authors
 Sun Jeong Byun  ;  Seung Up Kim  ;  Jun Yong Park  ;  Beom Kyung Kim  ;  Do Young Kim  ;  Kwang Hyub Han  ;  Chae Yoon Chon  ;  Sang Hoon Ahn 
Citation
 YONSEI MEDICAL JOURNAL, Vol.53(2) : 318-327, 2012 
Journal Title
 YONSEI MEDICAL JOURNAL 
ISSN
 0513-5796 
Issue Date
2012
MeSH
Adult ; Aged ; Aged, 80 and over ; Endoscopy, Gastrointestinal ; Female ; Gastrointestinal Hemorrhage/etiology ; Gastrointestinal Hemorrhage/mortality ; Gastrointestinal Hemorrhage/physiopathology* ; Hospitalization/statistics & numerical data* ; Humans ; Liver Cirrhosis/complications* ; Liver Cirrhosis/mortality ; Liver Cirrhosis/physiopathology* ; Logistic Models ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Time Factors
Keywords
Cirrhosis ; endoscopy ; esophageal and gastric varices ; hemorrhage ; mortality
Abstract
PURPOSE: Little is known about the impact of weekend admission on acute variceal hemorrhage (AVH). Thus, we investigated whether day of admission due to AVH influenced in-hospital mortality. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 294 patients with cirrhosis admitted between January 2005 and February 2009 for the management of AVH. Clinical characteristics were compared between patients with weekend and weekday admission, and independent risk factors for in-hospital mortality were determined by multivariate binary logistic regression analysis. RESULTS: No demographic differences were observed between patients according to admission day or in the clinical course during hospitalization. Seventeen (23.0%) of 74 patients with weekend admission and 48 (21.8%) of 220 with weekday admission died during hospitalization (p=0.872). Univariate and subsequent multivariate analysis showed that initial presentation with hematochezia [p=0.042; hazard ratio (HR), 2.605; 95% confidence interval (CI), 1.038-6.541], in-patient status at the time of bleeding (p=0.003; HR, 4.084; 95% CI, 1.598-10.435), Child-Pugh score (p<0.001; HR, 1.877; 95% CI, 1.516-2.324), and number of endoscopy sessions for complete hemostasis (p=0.001; HR, 3.864; 95% CI, 1.802-8.288) were independent predictors for in-hospital mortality. CONCLUSION: Weekend admission did not influence in-hospital mortality in patients with cirrhosis who presented AVH.
Files in This Item:
T201201842.pdf Download
DOI
22318819
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영)
Kim, Beom Kyung(김범경) ORCID logo https://orcid.org/0000-0002-5363-2496
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Byun, Sun Jeong(변선정)
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Chon, Chae Yoon(전재윤)
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/92092
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