No Significant Difference Between Weekday and Weekend Care in Patients with Lower GI Bleeding

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Patients with acute lower gastrointestinal bleeding (LGIB) had similar clinical outcomes regardless of admission day.

Patients admitted to the hospital for acute lower gastrointestinal bleeding (LGIB) showed similar outcomes regardless of whether they received care on a weekday or over the weekend, according to results of a retrospective cohort study published in Gastroenterological Endoscopy.

Researchers mined the 2016 US National Inpatient Sample dataset and retrospectively recruited 124,620 patients admitted to the hospital with acute LGIB. Patients were stratified by admittance day (weekday vs weekend) and assessed for Elixhauser mortality scores, time to procedure, length of hospitalization, need for transfusions, and instance of shock.

Patients admitted during the weekend had longer wait times for their colonoscopy compared with those admitted during weekdays (within 1 day 23.0% vs 28.6%; P <.001), lower infusion rates (31.5% vs 34%; P <.001), and greater instance of shock (3.8% vs 3.1%, P =.019). Other clinical outcomes did not significantly differ, including unadjusted morality (1.0% vs 0.9%; P =.636), colonoscopy rate (60.9% vs 60.7%; P =.818), angiography rate (2.7% vs 2.7%; P =.976), and length of stay (4.1 vs 4.2 days; P =.068) for weekend vs weekday, respectively.

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The overall adjusted mortality rate was calculated as an odds ratio (OR) of 1.11 (95% CI, 0.81-1.54; P =.495) for all patients admitted with acute LGIB. While admittance day was not noted to be a predictor of mortality, the investigators reported that undergoing a colonoscopy (OR, 0.31; 95% CI, 0.23-0.42; P <.001) and instance of shock (OR, 8.20; 95% CI, 5.85-11.51; P <.001) were significantly correlated in the patient population.

One limitation of this study is that it is based on hospital billing codes. Clinical information about participants, such as blood pressure or current drug treatments, were unavailable for inclusion in the model.

The study authors concluded that day of hospital admittance for acute LGIB did not impact patient outcomes. Although patients admitted during the week were more likely to undergo an endoscopy within 1 day, the total duration of their hospital stay was also unaffected.

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Li B, Stein D J, Schwartz J, et al. Outcomes in lower GI bleeding comparing weekend with weekday admission. [available online April 21, 2020]. Gastrointest Endosc. doi:10.1016/j.gie.2020.04.031