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Weekend Admission for Acute Cholangitis Does Not Adversely Impact Clinical or Endoscopic Outcomes

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Abstract

Background

Acute cholangitis (AC) requires prompt diagnosis and treatment for optimal management.

Aims

To examine whether a putative “weekend effect” impact outcomes of patients hospitalized for AC.

Methods

We conducted a retrospective study of patients admitted with AC between 2009 and 2012. After excluding those not meeting Tokyo consensus criteria for AC, the cohort was categorized into weekend (Saturday–Sunday) and weekday (Monday–Friday) hospital admission and endoscopic retrograde cholangiography (ERC) groups. Primary outcome was length of stay (LOS); secondary outcomes included ERC performance, organ failure, and mortality. Groups were compared with Chi-square and t tests; predictors of LOS were assessed with linear regression.

Results

The cohort consisted of 181 patients (mean age 63.1 years, 62.4 % male). Choledocholithiasis was the most common etiology of AC (29.4 %). Fifty-two patients (28.7 %) were admitted on a weekend and 129 (71.3 %) on a weekday. One hundred forty-one patients (78 %) underwent ERC, of which 120 (85 %) were on a weekday. There were no significant differences in baseline characteristics, LOS, proportion undergoing ERC, time to ERC, organ failure, or mortality between weekend and weekday admission groups. Similarly, there were no significant differences between weekend and weekday ERC groups. In multivariate analyses, international normalized ratio (p < 0.01) and intensive care unit triage (p < 0.01) were independent predictors of LOS, whereas weekend admission (p = 0.23) and weekend ERC (p = 0.74) were not.

Conclusions

Weekend admission and weekend ERC do not negatively impact outcomes of patients hospitalized with acute cholangitis at a tertiary care center. Further studies, particularly in centers with less weekend resources or staffing, are indicated.

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Acknowledgments

The authors thank Dr. Jason Puckett and Dr. Jennifer Martinez-Thompson for their assistance with data collection. Dr. Tabibian received training grant support from the National Institutes of Health (T32DK007198).

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA

    James H. Tabibian, Ju Dong Yang, Todd H. Baron, Sunanda V. Kane & Christopher J. Gostout

  2. Center for Endoscopic Education, Innovation, and Training, Division of Gastroenterology, University of Pennsylvania, Philadelphia, PA, USA

    James H. Tabibian

  3. Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, NC, USA

    Todd H. Baron

  4. Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA

    Felicity B. Enders

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  1. James H. Tabibian
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Correspondence to Christopher J. Gostout.

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Tabibian, J.H., Yang, J.D., Baron, T.H. et al. Weekend Admission for Acute Cholangitis Does Not Adversely Impact Clinical or Endoscopic Outcomes. Dig Dis Sci 61, 53–61 (2016). https://doi.org/10.1007/s10620-015-3853-z

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  • DOI: https://doi.org/10.1007/s10620-015-3853-z

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