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There is increasing complexity in the management of patients with acute severe exacerbation of inflammatory bowel disease with frequent requirement for urgent surgery. Dr Ananthakrishnan and colleagues determined whether a weekend effect exists for inflammatory bowel disease care in the United States. The team used data from the Nationwide Inpatient Sample 2007, the largest all-payer hospitalization database in the United States. The researchers identified discharges with a diagnosis of Crohn's disease or ulcerative colitis who underwent urgent intestinal surgery within 2 days of hospitalization using the appropriate ICD-9 codes. The researchers examined the independent effect of admission on a weekend using multivariate logistic regression adjusting for potential confounders. The research team evaluated 7,112 urgent intestinal surgeries in inflammatory bowel disease patients, 21% of which occurred following weekend admissions.  | | 21% of urgent intestinal surgeries occurred following weekend admissions | | Alimentary Pharmacology & Therapeutics |
The team of doctors found no difference in disease severity between weekend and weekday admissions. Post-operative complications were more common following weekend than weekday hospitalisations in ulcerative colitis. The researchers examined that the most common post-operative complication was post-operative infections. The most striking difference between weekend and weekday hospitalizations was noted for needing repeat laparotomy, mechanical wound complications and pulmonary complications. In contrast, occurrence of any post-operative complication in Crohn's disease was similar between weekday and weekend admissions. Dr Ananthakrishnan's team commented, "Patients with ulcerative colitis hospitalized on a weekend undergoing urgent surgery within 2 days have an increased risk for post-operative complications, in particular mechanical wound complications, need for repeat laparotomy and post-operative infections."
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