Outcome of Holiday and Nonholiday Admission Patients with Acute Peptic Ulcer Bleeding: A Real-World Report from Southern Taiwan

Abstract

Background. Recent findings suggest that patients admitted on the weekend with peptic ulcer bleeding might be at increased risk of adverse outcomes. However, other reports found that there was no “holiday effect.” The purpose of this study was to determine if these findings hold true for a real-life Taiwanese medical gastroenterology practice.Materials and Methods. We reviewed the medical files of hospital admissions for patients with peptic ulcer bleeding who received initial endoscopic hemostasis between January 2009 and March 2011. A total of 744 patients were enrolled (nonholiday group,n=615; holiday group,n=129) after applying strict exclusion criteria. Holidays were defined as weekends and national holidays in Taiwan.Results. Our results showed that there was no significant difference in baseline characteristics between the two groups. We also observed that, compared to the nonholiday group, patients in the holiday group received earlier endoscopy treatment (12.20 hours versus 16.68 hours,P=0.005), needed less transfused blood (4.8 units versus 6.6 units,P=0.02), shifted from intravenous to oral proton-pump inhibitors (PPIs) more quickly (5.3 days versus 6.9 days,P=0.05), and had shorter hospital stays (13.05 days versus 17.36 days,P=0.005). In the holiday and nonholiday groups, the rebleeding rates were 17.8% and 23.41% (P=0.167), the mortality rates were 11.63% versus 13.66% (P=0.537), and surgery was required in 2.11% versus 4.66% (P=0.093), respectively.Conclusions. Patients who presented with peptic ulcer bleeding on holidays did not experience delayed endoscopy or increased adverse outcomes. In fact, patients who received endoscopic hemostasis on the holiday had shorter waiting times, needed less transfused blood, switched to oral PPIs quicker, and experienced shorter hospital stays.