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- Title
Weekend hospitalisations and post-operative complications following urgent surgery for ulcerative colitis and Crohn's disease.
- Authors
Ananthakrishnan, A. N.; McGinley, E. L.
- Abstract
Background There is increasing complexity in the management of patients with acute severe exacerbation of inflammatory bowel disease [ IBD; Crohn's disease ( CD), ulcerative colitis ( UC)] with frequent requirement for urgent surgery. Aim To determine whether a weekend effect exists for IBD care in the United States. Methods We used data from the Nationwide Inpatient Sample ( NIS) 2007, the largest all-payer hospitalisation database in the United States. Discharges with a diagnosis of CD or UC who underwent urgent intestinal surgery within 2 days of hospitalisation were identified using the appropriate ICD-9 codes. The independent effect of admission on a weekend was examined using multivariate logistic regression adjusting for potential confounders. Results Our study included 7,112 urgent intestinal surgeries in IBD patients, 21% of which occurred following weekend admissions. There was no difference in disease severity between weekend and weekday admissions. Post-operative complications were more common following weekend than weekday hospitalisations in UC [odds ratio ( OR) 1.71, 95% confidence interval ( CI) 1.01-2.90]. The most common post-operative complication was post-operative infections (Weekend 30% vs. weekday 20%, P = 0.04). The most striking difference between weekend and weekday hospitalisations was noted for needing repeat laparotomy ( OR 11.5), mechanical wound complications ( OR 10.03) and pulmonary complications ( OR 2.22). In contrast, occurrence of any post-operative complication in CD was similar between weekday and weekend admissions. Conclusion Patients with UC hospitalised on a weekend undergoing urgent surgery within 2 days have an increased risk for post-operative complications, in particular mechanical wound complications, need for repeat laparotomy and post-operative infections.
- Subjects
UNITED States; ULCERATIVE colitis; CROHN'S disease diagnosis; SURGICAL complications; DISEASE exacerbation; INFLAMMATORY bowel diseases; MULTIPLE regression analysis; PATIENTS
- Publication
Alimentary Pharmacology & Therapeutics, 2013, Vol 37, Issue 9, p895
- ISSN
0269-2813
- Publication type
Article
- DOI
10.1111/apt.12272