Weekend admissions for upper gastrointestinal bleeding and their outcomes.

What is it about?

Patients who present to hospital "out of hours" (weekends and weeknights) for many conditions have a worse outcome than those presenting during the day. It is not clear whether this applies to patients admitted because of bleeding from the upper gastrointestinal tract (gullet, stomach, duodenum). If it does, it is not clear whether the worse outcome is because patients who present out of hours are often sicker. We studied admissions over 12 months in 4 international centres and looked at measures of how unwell patients were and then outcomes in relation to need for endoscopic treatment, blood transfusion, surgery and death.

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Why is it important?

This was a large study of 2118 patients in 4 international centres and we showed that patients presenting out of hours had no differences in co-morbidity (other diseases), pulse, blood pressure, endoscopic risk scores, frequency of peptic ulcers or varices. Patients presenting during the week were likely to have lower blood counts and to have a normal endoscopy. Time to endoscopy was actually less for patients presenting weeknights. Need for blood transfusion, endoscopic therapy, surgery and mortality rates did not differ with time of presentation.

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