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Weekend Effect on Clinical Outcomes of Acute Lower Gastrointestinal Bleeding: A Large Multicenter Cohort Study in Japan.
Hayasaka, Junnosuke; Kikuchi, Daisuke; Ishii, Naoki; Kobayashi, Katsumasa; Yamauchi, Atsushi; Yamada, Atsuo; Omori, Jun; Ikeya, Takashi; Aoyama, Taiki; Tominaga, Naoyuki; Sato, Yoshinori; Kishino, Takaaki; Sawada, Tsunaki; Murata, Masaki; Takao, Akinari; Mizukami, Kazuhiro; Kinjo, Ken; Fujimori, Shunji; Uotani, Takahiro; Fujita, Minoru; Sato, Hiroki; Suzuki, Sho; Narasaka, Toshiaki; Funabiki, Tomohiro; Kinjo, Yuzuru; Mizuki, Akira; Kiyotoki, Shu; Mikami, Tatsuya; Gushima, Ryosuke; Fujii, Hiroyuki; Fuyuno, Yuta; Gunji, Naohiko; Toya, Yosuke; Narimatsu, Kazuyuki; Manabe, Noriaki; Nagaike, Koji; Kinjo, Tetsu; Sumida, Yorinobu; Funakoshi, Sadahiro; Kobayashi, Kiyonori; Matsuhashi, Tamotsu; Komaki, Yuga; Miki, Kuniko; Watanabe, Kazuhiro; Odagiri, Hiroyuki; Hoteya, Shu; Kaise, Mitsuru; Nagata, Naoyoshi.
Affiliation
  • Hayasaka J; Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan.
  • Kikuchi D; Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan.
  • Ishii N; Department of Gastroenterology, Tokyo Shinagawa Hospital, Tokyo, Japan.
  • Kobayashi K; Department of Gastroenterology, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan.
  • Yamauchi A; Department of Gastroenterology and Hepatology, Kitano Hospital, Tazuke Kofukai Medical Research Institute, Osaka, Japan.
  • Yamada A; Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Omori J; Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine, Tokyo, Japan.
  • Ikeya T; Department of Gastroenterology, St. Luke's International University, Tokyo, Japan.
  • Aoyama T; Department of Gastroenterology, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan.
  • Tominaga N; Department of Gastroenterology, Saga-Ken Medical Centre Koseikan, Saga, Japan.
  • Sato Y; Division of Gastroenterology and Hepatology, Department of Internal Medicine, St Marianna University School of Medicine, Kawasaki, Japan.
  • Kishino T; Department of Gastroenterology and Hepatology, Center for Digestive and Liver Diseases, Nara City Hospital, Nara, Japan.
  • Sawada T; Department of Endoscopy, Nagoya University Hospital, Nagoya, Japan.
  • Murata M; Department of Gastroenterology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.
  • Takao A; Department of Gastroenterology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan.
  • Mizukami K; Department of Gastroenterology, Oita University, Oita, Japan.
  • Kinjo K; Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
  • Fujimori S; Department of Gastroenterology, Chiba Hokusoh Hospital, Nippon Medical School, Chiba, Japan.
  • Uotani T; Department of Gastroenterology, Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan.
  • Fujita M; Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School General Medical Center, Okayama, Japan.
  • Sato H; Division of Gastroenterology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
  • Suzuki S; Division of Endoscopy, Department of Gastroenterology and Hepatology, Center for Digestive Disease and University of Miyazaki Hospital, Miyazaki, Japan.
  • Narasaka T; Department of Gastroenterology, University of Tsukuba, Tsukuba, Japan.
  • Funabiki T; Division of Endoscopic Center, University of Tsukuba Hospital, Tsukuba, Japan.
  • Kinjo Y; Department of Emergency Medicine, Fujita Health University Hospital, Toyoake, Japan.
  • Mizuki A; Emergency and Critical Care Center, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Japan.
  • Kiyotoki S; Department of Gastroenterology, Naha City Hospital, Okinawa, Japan.
  • Mikami T; Department of Internal Medicine, Tokyo Saiseikai Central Hospital, Tokyo, Japan.
  • Gushima R; Department of Gastroenterology, Shuto General Hospital, Yamaguchi, Japan.
  • Fujii H; Division of Endoscopy, Hirosaki University Hospital, Aomori, Japan.
  • Fuyuno Y; Department of Gastroenterology and Hepatology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
  • Gunji N; Department of Gastroenterology and Hepatology, National Hospital Organization Fukuokahigashi Medical Center, Fukuoka, Japan.
  • Toya Y; Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
  • Narimatsu K; Department of Gastroenterology, Fukushima Medical University, Fukushima, Japan.
  • Manabe N; Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University, Morioka, Japan.
  • Nagaike K; Department of Internal Medicine, National Defense Medical College, Saitama, Japan.
  • Kinjo T; Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School, Okayama, Japan.
  • Sumida Y; Department of Gastroenterology and Hepatology, Suita Municipal Hospital, Osaka, Japan.
  • Funakoshi S; Department of Endoscopy, University of the Ryukyu Hospital, Okinawa, Japan.
  • Kobayashi K; Department of Gastroenterology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
  • Matsuhashi T; Department of Gastroenterological Endoscopy, Fukuoka University Hospital, Fukuoka, Japan.
  • Komaki Y; Department of Gastroenterology, Kitasato University, School of Medicine, Sagamihara, Japan.
  • Miki K; Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, Akita, Japan.
  • Watanabe K; Digestive and Lifestyle Diseases, and Hygiene and Health Promotion Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
  • Odagiri H; Department of Gastroenterological Endoscopy, Tokyo Medical University, Tokyo, Japan.
  • Hoteya S; Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo, Japan.
  • Kaise M; Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan.
  • Nagata N; Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan.
Dig Dis ; 41(6): 890-899, 2023.
Article in En | MEDLINE | ID: mdl-37669627
ABSTRACT

INTRODUCTION:

Weekend admissions showed increased mortality in several medical conditions. This study aimed to examine the weekend effect on acute lower gastrointestinal bleeding (ALGIB) and its mortality and other outcomes.

METHODS:

This retrospective cohort study (CODE BLUE-J Study) was conducted at 49 Japanese hospitals between January 2010 and December 2019. In total, 8,120 outpatients with acute hematochezia were enrolled and divided into weekend admissions and weekday admissions groups. Multiple imputation (MI) was used to handle missing values, followed by propensity score matching (PSM) to compare outcomes. The primary outcome was mortality; the secondary outcomes were rebleeding, length of stay (LOS), blood transfusion, thromboembolism, endoscopic treatment, the need for interventional radiology, and the need for surgery. Colonoscopy and computed tomography (CT) management were also evaluated.

RESULTS:

Before PSM, there was no significant difference in mortality (1.3% vs. 0.9%, p = 0.133) between weekend and weekday admissions. After PSM with MI, 1,976 cases were matched for each admission. Mortality was not significantly different for weekend admissions compared with weekday admissions (odds ratio [OR] 1.437, 95% confidence interval [CI] 0.785-2.630; p = 0.340). No significant difference was found with other secondary outcomes in weekend admissions except for blood transfusion (OR 1.239, 95% CI 1.084-1.417; p = 0.006). Weekend admission had a negative effect on early colonoscopy (OR 0.536, 95% CI 0.471-0.609; p < 0.001). Meanwhile, urgent CT remained significantly higher in weekend admissions (OR 1.466, 95% CI 1.295-1.660; p < 0.001).

CONCLUSION:

Weekend admissions decrease early colonoscopy and increase urgent CT but do not affect mortality or other outcomes except transfusion.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Patient Admission / Gastrointestinal Hemorrhage Type of study: Clinical_trials / Etiology_studies / Observational_studies Limits: Humans Country/Region as subject: Asia Language: En Journal: Dig Dis Journal subject: GASTROENTEROLOGIA Year: 2023 Document type: Article Affiliation country: Japón
Fulltext
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Patient Admission / Gastrointestinal Hemorrhage Type of study: Clinical_trials / Etiology_studies / Observational_studies Limits: Humans Country/Region as subject: Asia Language: En Journal: Dig Dis Journal subject: GASTROENTEROLOGIA Year: 2023 Document type: Article Affiliation country: Japón