Xian Feng Xia1, Philip Wai Yan Chiu1,2, Kelvin Kam Fai Tsoi2,3, Francis Ka Leung Chan2, Joseph Jao Yiu Sung2, James Yun Wong Lau1,2. 1. Department of Surgery, Institute of Digestive Disease, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong. 2. Department of Medicine and Therapeutics, Institute of Digestive Disease, State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong. 3. School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.
Abstract
OBJECTIVE: The objective of this article is to evaluate the relationship between off-hours hospital admission (weekends, public holidays or nighttime) and mortality for upper gastrointestinal hemorrhage (UGIH). METHODS: Medline, Embase, Scopus, and the Chinese Biomedical Literature were searched through December 2016 to identify eligible records for inclusion in this meta-analysis. A random-effects model was applied. RESULTS: Twenty cohort studies were included for analysis. Patients with UGIH who were admitted during off-hours had a significantly higher mortality and were less likely to receive endoscopy within 24 hours of admission. In comparison to variceal cases, patients with nonvariceal bleeding showed a higher mortality when admitted during off-hours. However, for studies conducted in hospitals that provided endoscopy outside normal hours, off-hours admission was not associated with an increased risk of mortality. CONCLUSION: Our study showed a higher mortality for patients with nonvariceal UGIH who were admitted during off-hours, while this effect might be offset in hospitals with a formal out-of-hours endoscopy on-call rotation.
OBJECTIVE: The objective of this article is to evaluate the relationship between off-hours hospital admission (weekends, public holidays or nighttime) and mortality for upper gastrointestinal hemorrhage (UGIH). METHODS: Medline, Embase, Scopus, and the Chinese Biomedical Literature were searched through December 2016 to identify eligible records for inclusion in this meta-analysis. A random-effects model was applied. RESULTS: Twenty cohort studies were included for analysis. Patients with UGIH who were admitted during off-hours had a significantly higher mortality and were less likely to receive endoscopy within 24 hours of admission. In comparison to variceal cases, patients with nonvariceal bleeding showed a higher mortality when admitted during off-hours. However, for studies conducted in hospitals that provided endoscopy outside normal hours, off-hours admission was not associated with an increased risk of mortality. CONCLUSION: Our study showed a higher mortality for patients with nonvariceal UGIH who were admitted during off-hours, while this effect might be offset in hospitals with a formal out-of-hours endoscopy on-call rotation.
Authors: Kelvin K F Tsoi; Philip W Y Chiu; Francis K L Chan; Jessica Y L Ching; James Y W Lau; Joseph J Y Sung Journal: Am J Gastroenterol Date: 2011-11-22 Impact factor: 10.864
Authors: V Jairath; B C Kahan; R F A Logan; S A Hearnshaw; S P L Travis; M F Murphy; K R Palmer Journal: Am J Gastroenterol Date: 2011-05-24 Impact factor: 10.864
Authors: L G Lim; K Y Ho; Y H Chan; P L Teoh; C J Khor; L L Lim; A Rajnakova; T Z Ong; K G Yeoh Journal: Endoscopy Date: 2011-02-28 Impact factor: 10.093
Authors: Steve Serrao; Christian Jackson; David Juma; Diana Babayan; Lauren B Gerson Journal: Gastrointest Endosc Date: 2016-03-10 Impact factor: 9.427
Authors: Jakub Nozewski; Grzegorz Grzesk; Maria Klopocka; Michal Wicinski; Klara Nicpon-Nozewska; Jakub Konieczny; Adam Wlodarczyk Journal: Vasc Health Risk Manag Date: 2021-03-31
Authors: Alan N Barkun; Majid Almadi; Ernst J Kuipers; Loren Laine; Joseph Sung; Frances Tse; Grigorios I Leontiadis; Neena S Abraham; Xavier Calvet; Francis K L Chan; James Douketis; Robert Enns; Ian M Gralnek; Vipul Jairath; Dennis Jensen; James Lau; Gregory Y H Lip; Romaric Loffroy; Fauze Maluf-Filho; Andrew C Meltzer; Nageshwar Reddy; John R Saltzman; John K Marshall; Marc Bardou Journal: Ann Intern Med Date: 2019-10-22 Impact factor: 25.391