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 23 June 2018

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News

Weekend vs weekday admissions for cholangitis requiring an ERCP

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A study in the latest issue of the Alimentary Pharmacology & Therapeutics compares weekend with weekday admissions for cholangitis requiring an ERCP.

News image

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There has been increasing medical literature showing worse outcomes in patients admitted for medical and surgical conditions on the weekend.

This has been termed the weekend effect.

Little is known whether this weekend effect occurs for patients with cholangitis who require endoscopic retrograde cholangiopancreatography (ERCP), a procedure that requires many resources from the nursing staff, anesthesia, and the endoscopist.

Dr Arvind Trindade and colleagues from New York, USA performed a retrospective analysis from the National Inpatient Sample (NIS) database from 2009 through 2012.

Patient data were abstracted from the database for patients admitted on the weekend and weekday with cholangitis who underwent ERCP.

77% of patients were admitted on the weekday
American Journal of Gastroenterology

Time to ERCP, length of stay, total cost, and mortality were compared in patients admitted with cholangitis on the weekend vs. weekday who required ERCP.

The researchers recorded ERCP adverse events from the weekend vs. weekday as well.

The team identified 23,661 patients in the NIS database who were admitted for cholangitis who required ERCP in the study period.

Of these, the team observed that 77% of patients were admitted on the weekday, whereas 24% were admitted on the weekend.

By 24 hours, the weekday group had undergone ERCP more frequently than the eekend group.

By 48 hours, the weekday group had undergone ERCP more frequently than the weekend group.

By 72 hours, the research team found that both groups had undergone a similar rate of ERCP.

The researchers found no statistical difference between the groups for in-hospital all-cause mortality, length of stay, or total cost of hospitalization.

Dr Trinidade's team comments, "Despite a delay in regard to time to ERCP for weekend admissions, there was no weekend effect observed in regard to length of stay, mortality, or total cost of hospitalization."

"Although biliary drainage with ERCP is important, these results suggest that other factors in the management of cholangitis contribute to outcomes."

Am J Gastroenterol 2016; 111:405–410
11 April 2016

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