Effect of holiday admission on clinical outcome of patients with upper gastrointestinal bleeding: A real-world report from Thailand

Chang, Arunchai; Ouejiaraphant, Chokethawee; Pungpipattrakul, Nuttanit; Akarapatima, Keerati; Rattanasupar, Attapon; Prachayakul, Varayu

doi:10.1016/j.heliyon.2022.e10344

Cited by 3 publications

(3 citation statements)

References 40 publications

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“…Another study showed that patients with UGIB admitted on holidays had a lower rate of early endoscopy, longer time to endoscopy, and higher admission costs than those admitted on non-holidays. 36 Therefore, the findings of our study suggest that if sufficient resources and services are available, patients should be transferred to a specialized ward faster, and medical staff are more likely to be able to adopt best practices. Moreover, two patients did not start oral feeding within 24 h, suggesting that the clinical judgment of the physician and the patient’s own situation should be combined to comprehensively assess whether an open diet within 24 h is beneficial to the patient.…”

Section: Discussionmentioning

confidence: 80%

Clinical Pathway for Enhanced Recovery in the Management of Non-Variceal Upper Gastrointestinal Bleeding: A Randomized Controlled Trial

Zhang,

et al. 2023

RMHP

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Purpose To explore the effects of the clinical pathway on the outcomes of patients with non-variceal upper gastrointestinal bleeding. Materials and Methods Randomized controlled trial. The study was conducted in two medical centers in China from 1 June 2022 to 31 December 2022. Patients with a diagnosis of non-variceal upper gastrointestinal bleeding who provided written informed consent were consecutively assigned to the intervention group. The patients in the intervention group were treated using the clinical pathway, while the control group received routine care and follow-up. Time, cost, complications, and prognostic indicators were analyzed. Intentional-to-treat analysis and per-protocol analysis were used for data analysis. Results A total of 114 eligible patients with non-variceal upper gastrointestinal bleeding were randomly divided into two groups and included in the intention-to-treat analysis. In addition, 106 patients were included in the per-protocol analysis. The median age of the 106 patients was 57 years (range, 18–92 years) and 83.0% were male. There were no significant differences between groups regarding the baseline characteristics. The intervention group demonstrated a statistically significantly shorter length of stay, lower hospital cost (ie, cost during hospitalization, cost in the emergency room, and cost in the ward), significantly fewer cases of complications, and a higher level of patient satisfaction when compared with the control group. There was no significant difference between the two groups in the rates of transfusion, repeat endoscopy, rebleeding readmission, and mortality. Conclusion The implementation of the clinical pathway for patients with non-variceal upper gastrointestinal bleeding may help improve patient outcomes and satisfaction. Trial Registration Number ChiCTR2200060316. Registration Link https://www.chictr.org.cn/ .

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Section: Discussionmentioning

confidence: 80%

Clinical Pathway for Enhanced Recovery in the Management of Non-Variceal Upper Gastrointestinal Bleeding: A Randomized Controlled Trial

Zhang,

et al. 2023

RMHP

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“…14 However, adherence to this recommendation worldwide remains low for several reasons, mainly lack of local medical resources. 38,39 As at several centers in developing countries, interventional radiologist was not available for 24/7 basic in our institute, which may have resulted in lower use of angioembolization.…”

Section: Discussionmentioning

confidence: 99%

Comparison of scoring systems for predicting clinical outcomes of acute lower gastrointestinal bleeding: A prospective cohort study

Prasitvarakul,

Attanath,

Chang

2023

World j. surg.

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BackgroundThis study aimed to determine the performance of the Oakland, Glasgow‐Blatchford, and AIMS65 scores in predicting the clinical outcomes of acute lower gastrointestinal bleeding (LGIB).MethodsThis prospective cohort study was conducted from July 2020 to July 2021. Patients admitted with acute lower gastrointestinal bleeding were enrolled. The Oakland, Glasgow‐Blatchford, and AIMS65 scores were calculated. The primary outcome was validating the performance of the scores in predicting severe LGIB; secondary outcomes were comparing the performance of the scores in predicting the need for blood transfusion, hemostatic interventions, in‐hospital rebleeding, and mortality. Receiver operating characteristic curves were calculated for all outcomes. The associations between all three scores and the primary outcomes were calculated using multivariate logistic regression analysis.ResultsPatients with acute LGIB (n = 150) were enrolled (88 [58.7%] men and mean age: 63.6 ± 17.3 years). The rates of severe LGIB, need for blood transfusion, hemostatic intervention, in‐hospital rebleeding, and in‐hospital mortality were 54.7%, 79.3%, 10.7%, and 3.3%, respectively. The Oakland and Glasgow‐Blatchford scores had comparable performance in predicting severe LGIB, need for blood transfusion, and mortality, outperforming the AIMS65 score. All scores were suboptimal for predicting hemostatic interventions and rebleeding.ConclusionsOur results demonstrate the predictive performances of the Oakland score and the GBS are excellent and comparable for severe LGIB, the need for blood transfusion, and in‐hospital mortality in patients with acute LGIB. Thus, GBS could be considered as an alternative predictive score for stratification of the patients with acute LGIB.

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“…5 To give an example of another disease, a study conducted with patients who visited with upper gastrointestinal bleeding during the holiday period observed that patients admitted on holidays had a lower rate of early endoscopy. 6 If we look at the events from a cardiology view, one of the branches with which the ED communicates closely, as a result of a meta-analysis conducted in acute myocardial infarction (MI) patients, it was observed that the short and long-term mortality of patients who visited during nonworking hours was higher than on weekdays. 7 In a study of 22,727 heart failure admissions, it was observed that there were more heart failure-related hospitalizations on Christmas and Independence Day.…”

Section: Introductionmentioning

confidence: 99%

The effect of long holidays on emergency department visits and cardiac emergencies

Polat¹,

Demir²,

Kılıçaslan³

2023

JCCVS

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Aims: Patients who visit the emergency department (ED) on holidays have delays in diagnosis and treatment due to a lack of personnel and equipment, and these holiday periods may result in increased morbidity and mortality. In this study, we aimed to investigate the impact of a nine-day holiday on ED admissions and admissions due to cardiac complaints in our country, Turkey. Methods: This was a retrospective study. Patients were analyzed in 4 periods: Pre-Eid-El-Fitr, Eid-El-Fitr, pre-Eid al-Adha, and Eid al-Adha. Waiting times in the ED, the left without being seen (LWBS), consultations, admission diagnoses of cardiac patients, referral status of cardiac patients, and hospitalization were examined. Results: The most frequent visits to the ED were on Eid al-Adha (n=6581, 40.1 %). The waiting time before the ED examination increased with the crowd, and the longest waiting time was observed during Eid al-Adha (38.09 ±51.74 min, p<0.001). LWBS rate was the highest during the Eid al-Adha (15.4%). It was observed that cardiac emergencies had shorter waiting times. Among the cardiac emergency patients, all NSTEMI patients could not be referred from the ED during the Eid al-Adha period due to the fullness of the angiography centers, and the patients were transferred to the intensive care unit when the beds became available. Conclusion: Due to the crowded EDs during extended holiday periods, the triage system gains importance for the early detection and treatment of cardiac patients. A regular patient flow chart should be established on a provincial basis to avoid delays in the treatment process of patients needing angiography.

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Effect of holiday admission on clinical outcome of patients with upper gastrointestinal bleeding: A real-world report from Thailand

Cited by 3 publications

References 40 publications

Clinical Pathway for Enhanced Recovery in the Management of Non-Variceal Upper Gastrointestinal Bleeding: A Randomized Controlled Trial

Clinical Pathway for Enhanced Recovery in the Management of Non-Variceal Upper Gastrointestinal Bleeding: A Randomized Controlled Trial

Comparison of scoring systems for predicting clinical outcomes of acute lower gastrointestinal bleeding: A prospective cohort study

The effect of long holidays on emergency department visits and cardiac emergencies

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