Post written by Daniel J. Stein, MD, MPH, from the Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA.
We know that acute lower gastrointestinal bleeding is common in the inpatient setting and can require urgent intervention. Our focus was to determine if being admitted on a weekend with more limited hospital resources leads to worsened outcomes.
There is limited existing data on the differences between weekend versus weekday admissions. We aimed to see if both process (time to colonoscopy, hospital charges) and patient-oriented (mortality, length of stay) outcomes were impacted.
There were an estimated 124,620 patients admitted with lower-GI bleeding in 2016. There was no difference in unadjusted or multivariable-adjusted mortality, but colonoscopy within the first day (28.6% vs 23.0%, P<0.001) and transfusion (34.0% vs 31.5%, P<0.001) were more common with weekday admissions. Need for angiography, mean days to colonoscopy, and length of stay were all similar. Overall, we found that colonoscopy within the first day is more common for weekday admissions, but overall outcomes are not affected by weekend admission for LGIB as compared to weekday admissions. This indicates that the current national practice is sufficient for management.
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