Effect of Admission Time on the Outcomes of Liver Cirrhosis with Acute Upper Gastrointestinal Bleeding: Regular Hours versus Off-Hours Admission

Background and Aims. Acute upper gastrointestinal bleeding (AUGIB) is a lethal complication of liver cirrhosis. We aimed to compare the outcomes of patients with liver cirrhosis and AUGIB who were admitted to hospital on regular hours and off-hours. Methods. This retrospective study screened all cir...

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Main Authors: Yingying Li, Bing Han, Hongyu Li, Tingxue Song, Wenchun Bao, Ran Wang, Zhaohui Bai, Kexin Zheng, Qianqian Li, Xiaozhong Guo, Xingshun Qi
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Canadian Journal of Gastroenterology and Hepatology
Online Access:http://dx.doi.org/10.1155/2018/3541365
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author Yingying Li
Bing Han
Hongyu Li
Tingxue Song
Wenchun Bao
Ran Wang
Zhaohui Bai
Kexin Zheng
Qianqian Li
Xiaozhong Guo
Xingshun Qi
author_facet Yingying Li
Bing Han
Hongyu Li
Tingxue Song
Wenchun Bao
Ran Wang
Zhaohui Bai
Kexin Zheng
Qianqian Li
Xiaozhong Guo
Xingshun Qi
author_sort Yingying Li
collection DOAJ
description Background and Aims. Acute upper gastrointestinal bleeding (AUGIB) is a lethal complication of liver cirrhosis. We aimed to compare the outcomes of patients with liver cirrhosis and AUGIB who were admitted to hospital on regular hours and off-hours. Methods. This retrospective study screened all cirrhotic patients with AUGIB who were admitted to our hospital from January 2010 to June 2014 for the test cohort and from December 2014 to March 2018 for the validation cohort. A 1:1 propensity score matching analysis was performed to adjust the Child-Pugh and MELD scores. In-hospital mortality, 5-day rebleeding rate, length of stay, and total payment were primary outcomes. Results. Overall, 826 and 173 patients with liver cirrhosis and AUGIB were included in the test and validation cohorts, respectively. After propensity score matching, 226 and 40 patients were included in the test and validation cohorts, respectively. The overall analysis of the test cohort found significantly higher Child-Pugh score (P=0.006), 5-day rebleeding rate (18.69% versus 10.72%, P=0.001), and total payment (¥25,906.83 versus ¥22,017.42, P<0.001) in patients admitted on off-hours. By contrast, the overall analysis of the validation cohort did not find any difference in Child-Pugh score, 5-day rebleeding, in-hospital mortality, length of stay, or hospital payment between patients admitted on regular hours and off-hours. Similarly, the propensity score matching analyses of both test and validation cohorts found no difference in these primary outcomes between the two groups. Conclusions. Off-hours admission might not be negatively associated with the outcomes of patients with liver cirrhosis and AUGIB.
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spelling doaj-art-9379a4d0bef3423d8a26942faaa60ce22025-08-20T03:37:19ZengWileyCanadian Journal of Gastroenterology and Hepatology2291-27892291-27972018-01-01201810.1155/2018/35413653541365Effect of Admission Time on the Outcomes of Liver Cirrhosis with Acute Upper Gastrointestinal Bleeding: Regular Hours versus Off-Hours AdmissionYingying Li0Bing Han1Hongyu Li2Tingxue Song3Wenchun Bao4Ran Wang5Zhaohui Bai6Kexin Zheng7Qianqian Li8Xiaozhong Guo9Xingshun Qi10Department of Gastroenterology, General Hospital of Shenyang Military Area, Shenyang, 110840, ChinaDepartment of Gastroenterology, General Hospital of Shenyang Military Area, Shenyang, 110840, ChinaDepartment of Gastroenterology, General Hospital of Shenyang Military Area, Shenyang, 110840, ChinaDepartment of Gastroenterology, General Hospital of Shenyang Military Area, Shenyang, 110840, ChinaDepartment of Gastroenterology, General Hospital of Shenyang Military Area, Shenyang, 110840, ChinaDepartment of Gastroenterology, General Hospital of Shenyang Military Area, Shenyang, 110840, ChinaDepartment of Gastroenterology, General Hospital of Shenyang Military Area, Shenyang, 110840, ChinaDepartment of Gastroenterology, General Hospital of Shenyang Military Area, Shenyang, 110840, ChinaDepartment of Gastroenterology, General Hospital of Shenyang Military Area, Shenyang, 110840, ChinaDepartment of Gastroenterology, General Hospital of Shenyang Military Area, Shenyang, 110840, ChinaDepartment of Gastroenterology, General Hospital of Shenyang Military Area, Shenyang, 110840, ChinaBackground and Aims. Acute upper gastrointestinal bleeding (AUGIB) is a lethal complication of liver cirrhosis. We aimed to compare the outcomes of patients with liver cirrhosis and AUGIB who were admitted to hospital on regular hours and off-hours. Methods. This retrospective study screened all cirrhotic patients with AUGIB who were admitted to our hospital from January 2010 to June 2014 for the test cohort and from December 2014 to March 2018 for the validation cohort. A 1:1 propensity score matching analysis was performed to adjust the Child-Pugh and MELD scores. In-hospital mortality, 5-day rebleeding rate, length of stay, and total payment were primary outcomes. Results. Overall, 826 and 173 patients with liver cirrhosis and AUGIB were included in the test and validation cohorts, respectively. After propensity score matching, 226 and 40 patients were included in the test and validation cohorts, respectively. The overall analysis of the test cohort found significantly higher Child-Pugh score (P=0.006), 5-day rebleeding rate (18.69% versus 10.72%, P=0.001), and total payment (¥25,906.83 versus ¥22,017.42, P<0.001) in patients admitted on off-hours. By contrast, the overall analysis of the validation cohort did not find any difference in Child-Pugh score, 5-day rebleeding, in-hospital mortality, length of stay, or hospital payment between patients admitted on regular hours and off-hours. Similarly, the propensity score matching analyses of both test and validation cohorts found no difference in these primary outcomes between the two groups. Conclusions. Off-hours admission might not be negatively associated with the outcomes of patients with liver cirrhosis and AUGIB.http://dx.doi.org/10.1155/2018/3541365
spellingShingle Yingying Li
Bing Han
Hongyu Li
Tingxue Song
Wenchun Bao
Ran Wang
Zhaohui Bai
Kexin Zheng
Qianqian Li
Xiaozhong Guo
Xingshun Qi
Effect of Admission Time on the Outcomes of Liver Cirrhosis with Acute Upper Gastrointestinal Bleeding: Regular Hours versus Off-Hours Admission
Canadian Journal of Gastroenterology and Hepatology
title Effect of Admission Time on the Outcomes of Liver Cirrhosis with Acute Upper Gastrointestinal Bleeding: Regular Hours versus Off-Hours Admission
title_full Effect of Admission Time on the Outcomes of Liver Cirrhosis with Acute Upper Gastrointestinal Bleeding: Regular Hours versus Off-Hours Admission
title_fullStr Effect of Admission Time on the Outcomes of Liver Cirrhosis with Acute Upper Gastrointestinal Bleeding: Regular Hours versus Off-Hours Admission
title_full_unstemmed Effect of Admission Time on the Outcomes of Liver Cirrhosis with Acute Upper Gastrointestinal Bleeding: Regular Hours versus Off-Hours Admission
title_short Effect of Admission Time on the Outcomes of Liver Cirrhosis with Acute Upper Gastrointestinal Bleeding: Regular Hours versus Off-Hours Admission
title_sort effect of admission time on the outcomes of liver cirrhosis with acute upper gastrointestinal bleeding regular hours versus off hours admission
url http://dx.doi.org/10.1155/2018/3541365
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