Original article—alimentary tractOutcomes of Weekend Admissions for Upper Gastrointestinal Hemorrhage: A Nationwide Analysis
Section snippets
Data Source
We used data from the Nationwide Inpatient Sample (NIS) for the year 2004.17 This is the largest all-payer inpatient database in the United States and is part of the Healthcare Cost and Utilization Project of the Agency for Healthcare Research and Quality.18 The NIS contains information on nearly 8 million discharges from a 20% stratified sample of hospitals across 37 participating states, with the stratification based on hospital teaching status, number of beds, location, ownership, and
Acute Nonvariceal Upper Gastrointestinal Hemorrhage
There were 80,661 actual discharges that fit the case definition for NVUGIH in the NIS 2004 database. This yielded an adjusted national estimate of 301,357 hospitalizations related to NVUGIH admitted on a weekday and 89,762 hospitalizations admitted on one of the weekend days (23.0%) (total adjusted national estimate for all NVUGIH hospitalizations = 391,119). There were clinically small, but statistically significant, differences in demographic characteristics between weekday and weekend
Discussion
Previous studies have shown differences in outcomes between weekend and weekday admissions.1, 2, 4, 8, 10 However, there has been limited analysis focusing on patients with UGIH, a common medical emergency that carries significant morbidity and mortality. We examined the impact of weekend hospitalization for patients with UGIH and show the following: (1) NVUGIH patients admitted on weekends have a higher adjusted mortality and are less likely to undergo early endoscopy during their
Acknowledgements
This work was presented in part as an oral presentation at Digestive Disease Week, San Diego, California, May 17–22, 2008.
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2020, Health PolicyCitation Excerpt :The weekend effect, the phenomenon of patients admitted at the weekend having a higher mortality risk, has been widely investigated [1]. Evidence has been found for [2–10] and against [2,11] disease-specific weekend effects, with conflicting results for stroke [12–15], acute myocardial infarction (AMI) [16–19], and hip fracture [20–22]. In previous studies, systematic reviews and meta-analyses, emergency patients admitted at the weekend suffered higher in-hospital mortality across both medical and surgical diagnoses [23–27], with a larger risk in major teaching hospitals [28,29], with varying specialty-specific [30–36] and disease-specific [26,37–40] results.
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Conflicts of interest The authors disclose no conflicts.