title: The risk of peptic ulcer bleeding mortality in relation to hospital admission on holidays: a cohort study on 8,222 cases of peptic ulcer bleeding.
abstract: OBJECTIVE
  Urgent endoscopic intervention is important in the management of patients with peptic ulcer bleeding (PUB). Hospital admission on Sundays or on public holidays may be associated with an increased mortality. This study sets to investigate whether mortality among patients with PUB differs between holiday and weekday admissions, and also to investigate the association between mortality and the waiting time for endoscopy.
  
  
  METHODS
  Patients with PUB admitted to the Prince of Wales Hospital from 1993 to 2005 were prospectively recruited in the data set. Mortality and cause of death were documented. Predicting variables included patient characteristics, waiting time for endoscopy, and holiday or weekday admissions. Bivariate analyses and multivariate logistic regression models were used to evaluate risk factors on 30-day mortality after endoscopy.
  
  
  RESULTS
  A total of 8,222 patients with PUB were enrolled among which 1,573 (19.1%) were admitted on holidays. A total of 334 (4.1%) patients died within 30 days after hospital admission. There was no significant difference in mortality rate between holiday and weekday admissions (4.1 vs. 4.0%, P=0.876). Using logistic regression adjusted for age, hemodynamic shock, ulcer history, and severe comorbid illness, the waiting time for endoscopy was correlated with the risk of 30-day mortality (odds ratio (OR), 95% confidence interval (95% CI)=1.10, 1.06-1.14). Holiday admission has not increased the mortality risk (OR, 95% CI=1.07, 0.80-1.43).
  
  
  CONCLUSIONS
  When therapeutic endoscopy can be offered within 1 day after admission for PUB, holiday admission will not adversely affect bleeding mortality.
authors: Institute of Digestive Disease, the Chinese University of Hong Kong, Shatin, NT, Hong Kong.
authors: Kelvin K F
authors: KK
authors: Tsoi
authors: Philip W Y
authors: PW
authors: Chiu
authors: Francis K L
authors: FK
authors: Chan
authors: Jessica Y L
authors: JY
authors: Ching
authors: James Y W
authors: JY
authors: Lau
authors: Joseph J Y
authors: JJ
authors: Sung
mesh_terms: D015331:Cohort Studies; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006693:Holidays; D006723:Hong Kong / Q000453:epidemiology; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000401:mortality* / Q000628:therapy; D011379:Prognosis; D012042:Registries; D012306:Risk; D014850:Waiting Lists