Weekend effect in upper gastrointestinal bleeding: a systematic review and meta-analysis.

Area of Science:

• Gastroenterology
• Clinical Epidemiology
• Health Services Research

Background:

• The
• weekend effect
• describes potential disparities in healthcare outcomes between weekend and weekday admissions.
• Upper gastrointestinal bleeding (UGIB) is a significant cause of morbidity and mortality.

Purpose of the Study:

• To systematically review and meta-analyze the impact of the weekend effect on mortality in patients with upper gastrointestinal bleeding (UGIB).

Main Methods:

• A systematic search of multiple databases (PubMed, Cochrane, EMBASE, CINAHL) was conducted up to August 2017.
• Included were observational studies comparing mortality in UGIB patients admitted on weekends versus weekdays.
• Data were pooled using random-effects models, with heterogeneity assessed and addressed through sensitivity and subgroup analyses.

Main Results:

• Eighteen observational studies with over 1.2 million patients were analyzed.
• Weekend admission was associated with significantly higher 30-day or in-hospital mortality (OR = 1.12).
• A notable increase in mortality was observed for non-variceal bleeding (OR = 1.15), but not for variceal bleeding (OR = 0.99).
• Weekday admissions had a shorter time to endoscopy compared to weekend admissions (MD = -2.50).

Conclusions:

• The weekend effect is associated with increased mortality in upper gastrointestinal bleeding (UGIB) patients, especially those with non-variceal bleeding.
• The timing of endoscopic procedures may be a critical factor influencing mortality outcomes in UGIB patients.