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Weekend admissions with ascites are associated with delayed paracentesis: A nationwide analysis of the 'weekend effect'.
- Source :
-
Annals of hepatology [Ann Hepatol] 2020 Sep - Oct; Vol. 19 (5), pp. 523-529. Date of Electronic Publication: 2020 Jun 04. - Publication Year :
- 2020
-
Abstract
- Introduction and Objectives: Weekend admissions has previously been associated with worse outcomes in conditions requiring specialists. Our study aimed to determine in-hospital outcomes in patients with ascites admitted over the weekends versus weekdays. Time to paracentesis from admission was studied as current guidelines recommend paracentesis within 24h for all patients admitted with worsening ascites or signs and symptoms of sepsis/hepatic encephalopathy (HE).<br />Patients: We analyzed 70 million discharges from the 2005-2014 National Inpatient Sample to include all adult patients admitted non-electively for ascites, spontaneous bacterial peritonitis (SBP), and HE with ascites with cirrhosis as a secondary diagnosis. The outcomes were in-hospital mortality, complication rates, and resource utilization. Odds ratios (OR) and means were adjusted for confounders using multivariate regression analysis models.<br />Results: Out of the total 195,083 ascites/SBP/HE-related hospitalizations, 47,383 (24.2%) occurred on weekends. Weekend group had a higher number of patients on Medicare and had higher comorbidity burden. There was no difference in mortality rate, total complication rates, length of stay or total hospitalization charges between the patients admitted on the weekend or weekdays. However, patients admitted over the weekends were less likely to undergo paracentesis (OR 0.89) and paracentesis within 24h of admission (OR 0.71). The mean time to paracentesis was 2.96 days for weekend admissions vs. 2.73 days for weekday admissions.<br />Conclusions: We observed a statistically significant "weekend effect" in the duration to undergo paracentesis in patients with ascites/SBP/HE-related hospitalizations. However, it did not affect the patient's length of stay, hospitalization charges, and in-hospital mortality.<br /> (Copyright © 2020 Fundación Clínica Médica Sur, A.C. Published by Elsevier España, S.L.U. All rights reserved.)
- Subjects :
- After-Hours Care economics
Ascites diagnosis
Ascites economics
Ascites mortality
Databases, Factual
Female
Hospital Charges trends
Hospital Mortality trends
Humans
Inpatients
Length of Stay
Liver Cirrhosis diagnosis
Liver Cirrhosis economics
Liver Cirrhosis mortality
Male
Middle Aged
Paracentesis adverse effects
Paracentesis economics
Paracentesis mortality
Patient Admission economics
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Time-to-Treatment economics
Treatment Outcome
United States epidemiology
After-Hours Care trends
Ascites therapy
Liver Cirrhosis therapy
Paracentesis trends
Patient Admission trends
Time-to-Treatment trends
Subjects
Details
- Language :
- English
- ISSN :
- 1665-2681
- Volume :
- 19
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Annals of hepatology
- Publication Type :
- Academic Journal
- Accession number :
- 32540327
- Full Text :
- https://doi.org/10.1016/j.aohep.2020.05.005