title: Weekend and nighttime effect on the prognosis of peptic ulcer bleeding.
abstract: OBJECTIVE
  To evaluate whether weekend or nighttime admission affects prognosis of peptic ulcer bleeding despite early endoscopy.
  
  
  METHODS
  Retrospective data collection from four referral centers, all of which had a formal out-of-hours emergency endoscopy service, even at weekends. A total of 388 patients with bleeding peptic ulcers who were admitted via the emergency room between January 2007 and December 2009 were enrolled. Analyzed parameters included time from patients' arrival until endoscopy, mortality, rebleeding, need for surgery and length of hospital stay.
  
  
  RESULTS
  The weekday and weekend admission groups comprised 326 and 62 patients, respectively. There were no significant differences in baseline characteristics between the two groups, except for younger age in the weekend group. Most patients (97%) had undergone early endoscopy, which resulted in a low mortality rate regardless of point of presentation (1.8% overall vs 1.6% on the weekend). The only outcome that was worse in the weekend group was a higher rate of rebleeding (12% vs 21%, P = 0.030). However, multivariate analysis revealed nighttime admission and a high Rockall score (≥ 6) as significant independent risk factors for rebleeding, rather than weekend admission.
  
  
  CONCLUSIONS
  Early endoscopy for peptic ulcer bleeding can prevent the weekend effect, and nighttime admission was identified as a novel risk factor for rebleeding, namely the nighttime effect.
authors: Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 135-720, South Korea. dryoun@yuhs.ac
authors: Young Hoon
authors: YH
authors: Youn
authors: Yong Jin
authors: YJ
authors: Park
authors: Jae Hak
authors: JH
authors: Kim
authors: Tae Joo
authors: TJ
authors: Jeon
authors: Jae Hee
authors: JH
authors: Cho
authors: Hyojin
authors: H
authors: Park
mesh_terms: D039602:After-Hours Care; D016009:Chi-Square Distribution; D004636:Emergency Service, Hospital; D005260:Female; D006297:Health Services Accessibility; D016558:Hemostasis, Endoscopic / Q000009:adverse effects / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010438:Peptic Ulcer Hemorrhage / Q000473:pathology / Q000628:therapy*; D012008:Recurrence; D012086:Reoperation; D056910:Republic of Korea; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome