Lack of weekend endoscopy services could increase GI bleeding mortality rates

A study, presented at the World Congress of Gastroenterology at ACG2017, found a lack of weekend endoscopy services is possibly related to a significant increase in non-variceal upper gastrointestinal hemorrhaging, Medpage Today reports.

The World Congress of Gastroenterology at ACG2017 took place from Oct. 13 to Oct. 18 in Orlando, Fla.

Odessa, Texas-based Medical Center Health System Gastroenterologist Ashutosh Gupta, MD, and colleagues conducted a systematic review and meta-analysis of eight studies. They found there was a significant increase in patient mortality in patients with non-variceal upper gastrointestinal hemorrhage, but not in patients with variceal upper gastrointestinal hemorrhage.

Researchers then searched both Medline and Cochrane databases for keywords related to gastrointestinal hemorrhage and weekend effect. They identified 20 studies examining 592,293 patients — five studies related to variceal bleeding and eight related to non-variceal bleeding.

Researchers found no association between weekend admission and mortality in patients with upper gastrointestinal hemorrhage. Researchers did find that endoscopy timing made an impact. Six studies suggested an association between weekend endoscopy and mortality rate.

Dr. Gupta said, "Timing of endoscopy is one of the most crucial things that may have made a difference in variceal bleeding."

Weekend effect on mortality was most evident in U.S.-based studies. However, Dr. Gupta said database procedures could be related to that increase.

He concluded, "Overall weekend coverage is very important and there is clearly discrepancy. Our findings are relevant to policymakers and other stakeholders who should ensure the creation of consistent quality and access to care throughout the week."

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