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Absence of a Weekend Effect on In-Hospital Mortality in Upper Gastrointestinal Bleeding: A Multisite Study from an
Ali Sohail1, Uday Sankar Akash Vankayala2, Bivin George2
1Department of Medicine, Staten Island University Hospital, Northwell Health, 475 Seaview Avenue, Staten Island, NY, 10305, USA. asohail1@northwell.edu.
Digestive Diseases and Sciences
|August 3, 2026
Summary
Weekend admission for upper gastrointestinal bleeding (UGIB) did not lead to worse patient outcomes in a modern healthcare system. Continuous care availability mitigated potential disparities, with disease severity being the primary factor influencing mortality.
Area of Science:
- Gastroenterology
- Health Services Research
- Patient Outcomes
Background:
- The
- weekend effect
- suggests poorer outcomes for patients admitted on weekends, potentially due to reduced resources and delayed procedures like endoscopy.
- This effect has been observed in upper gastrointestinal bleeding (UGIB).
- Contemporary healthcare systems aim to mitigate such disparities through continuous care models.
Purpose of the Study:
- To investigate whether weekend admission is associated with adverse outcomes in patients with upper gastrointestinal bleeding (UGIB).
- To evaluate the impact of continuous endoscopy availability within an integrated health system on weekend admission outcomes.
Main Methods:
- A retrospective cohort study analyzed 7,640 adult patients admitted with UGIB between January 2019 and January 2024.
- Weekend admission was defined as arrival on Saturday or Sunday.
- Primary outcome was in-hospital mortality; secondary outcomes included ICU admission, length of stay, and 30-day readmission.
- Multivariable logistic regression adjusted for key clinical factors.
Main Results:
- Weekend admission (25.2% of patients) was not significantly associated with increased in-hospital mortality (aOR 1.06; P=0.67).
- No significant differences were observed in ICU admission, length of stay, or 30-day readmission rates between weekend and weekday admissions.
- Shock, liver cirrhosis, and age were independent predictors of mortality, not admission timing.
Conclusions:
- Weekend admission does not appear to worsen outcomes for patients with upper gastrointestinal bleeding in integrated health systems with continuous care.
- Standardized, continuously available care pathways effectively mitigate temporal disparities in UGIB outcomes.
- Disease severity, particularly shock and cirrhosis, remains the primary determinant of patient mortality.
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