Endoscopy 2018; 50(04): S54
DOI: 10.1055/s-0038-1637187
ESGE Days 2018 oral presentations
20.04.2018 – Best abstract awards
Georg Thieme Verlag KG Stuttgart · New York

THE IMPACT OF WEEKEND ADMISSION ON ACUTE CHOLANGITIS OUTCOMES: A NATIONWIDE ANALYSIS OF 67,630 PATIENTS

PT Kröner
1   Mayo Clinic, Jacksonville, United States
,
A Martínez-Alcalá García
2   Hospital Universitario Infanta Leonor, Madrid, Spain
,
MA D'Assuncao
3   Hospital Sirio Libanes, Sao Paulo, Brazil
,
M Wallace
1   Mayo Clinic, Jacksonville, United States
,
K Mönkemüller
4   Frankenwald Klinik, Kronach, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

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Aims:

To assess the impact of weekend admission on acute cholangitis mortality and resource utilization.

Methods:

Retrospective cohort study using the National Inpatient Sample, the largest publically available inpatient database in the United States. The primary outcome was in-hospital mortality. Secondary outcomes were morbidity (shock, ICU stay and multi-organ failure); resource utilization, length of stay, hospitalization costs. Multivariate logistic regression analysis was adjusted for age, sex, race, income, Charlson Comorbidity Index, hospital region, rural location, size and teaching status. Patients were propensity-matched in a 1:1 fashion and regressed against gender, age, race and Charlson Comorbidity Index.

Results:

Out of 67,630 patients with acute cholangitis, 29,910 were matched with controls and were included in the study. Mean age was 65 years and 49% were female. Patients admitted during the weekend did not display significantly different odds of mortality when compared to patients admitted during the weekdays (aOR: 1.15, 95% CI: 0.90 – 1.49, p = 0.27). ERCP use had no influnce on outcome. Patients admitted during the weekend displayed greater odds of ICU stay (aOR: 1.35, p < 0.01) and CT abdomen use (aOR: 2.03, p < 0.01), while having similar adjusted odds of shock, multi-organ failure, ERCP and abdominal ultrasound when compared to patients admitted during the weekdays. Patients admitted during the weekend displayed significantly increased total hospitalization charges (adj. mean:$14,372, p < 0.01) when compared to patients admitted during the weekdays. No differences were observed in terms of hospital length of stay.

Conclusions:

Weekend admission of patients with acute cholangitis is not associated with increased morbidity or mortality when compared with patients admitted on weekdays. However, patients admitted on the weekend displayed higher odds of ICU admission and abdominal CT use. This translated into higher additional total hospitalization charges and costs. Interestingly, hospital length of stay did not differ in patients admitted on weekends when compared to patients admitted on weekdays.