The weekend effect in patients hospitalized for upper gastrointestinal bleeding: A single-center 10-year experience

Maja Tufegdzic, Nikola Panic, Stefania Boccia, Stefano Malerba, Milutin Bulajic, Carlo La Vecchia, Aleksandra Sljivic, Jasna Trbojevic-Stankovic, Miodrag Krstic

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: This study was conducted to assess the possible weekend effect in patients with upper gastrointestinal bleeding (UGIB) on the basis of a 10-year single-center experience in Serbia. MATERIALS AND METHODS: A retrospective analysis of hospital records in the University Clinic 'Dr Dragisa Misovic-Dedinje', Belgrade, Serbia, from 2002 to 2012 was conducted. Patients admitted for UGIB were identified, and data on demographic characteristics, symptoms, drug use, alcohol abuse, diagnosis and treatment were collected. Univariate and multivariate logistic regression were used to assess the association between weekend admission and the occurrence of rebleeding and in-hospital mortality. RESULTS: Analyses included 493 patients. Rebleeding occurred significantly more frequently on weekends (45.7 vs. 32.7%, P=0.004). Weekend admission [odds ratio (OR)=1.78; 95% confidence interval (CI): 1.15-2.74], older age (OR=1.02; 95% CI: 1.00-1.03), and the presence of both melaena and hematemesis (OR=2.29; 95% CI: 1.29-4.07) were associated with the occurrence of rebleeding. No difference between weekend and weekday admissions was observed for the in-hospital mortality rate (6.9% vs. 6.0%, P=0.70). Older age (OR=1.14; 95% CI: 1.08-1.20), presentation with melaena and hematemesis (OR=4.12; 95% CI: 1.56-10.90) and need for surgical treatment (OR=5.16; 95% CI: 1.61-16.53) were significant predictors of all-cause mortality. Patients with nonvariceal bleeding had significantly higher rebleeding rates on weekends (44 vs. 32.3%, P=0.013). CONCLUSION: There was no significant weekend effect in the mortality of patients admitted for UGIB, irrespective of the source of bleeding. Increased attention to older patients presenting with a more severe clinical picture is needed to prolong survival and prevent rebleeding.

Original languageEnglish
Pages (from-to)715-720
Number of pages6
JournalEuropean Journal of Gastroenterology and Hepatology
Volume26
Issue number7
DOIs
Publication statusPublished - 2014

Keywords

  • Complications
  • Mortality
  • Upper gastrointestinal bleeding
  • Weekend effect

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology
  • Medicine(all)

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