P4183 - Clinical Outcomes in Lower Gastrointestinal Bleeding for Patients Admitted During the Weekend: An Analysis of the National Inpatient Sample 2016-2020

Christopher Chhoun, DO¹, Fanchen Zhou, MBA², Anudeep Jala, DO¹, Jason John, DO³, Neethi Dasu, DO⁴, Yaser Khalid, DO⁵, C. Jonathan Foster, DO⁶, Lucy Joo, DO^6
1Jefferson Health, Washington Township, NJ; ²University of Pennsylvania, New York, NY; ³Jefferson Health, Pennsauken, NJ; ⁴Beth Israel Lahey Health, Burlington, MA; ⁵Wright Center GME, Scranton, PA; ⁶Jefferson Health, Cherry Hill, NJ

Introduction: Studies have shown that patients admitted to the hospital on a weekend tend to have poorer outcomes, possibly due to differences in staffing and coverage. The aim of this study was to investigate the outcomes of patients admitted to the hospital for lower GI bleed on a weekend. This study compares mortality, average length of stay (LOS), and total hospitalization costs in patients who underwent colonoscopy within 2 days of admission versus those that underwent colonoscopy after 2 days of admission.

Methods: The National Inpatient Sample (NIS) database (2016-2020) was analyzed to identify adult patients admitted with ICD-10 CM/PCS codes for lower GI bleeds and weekend admissions. Multivariate logistic/linear regression analysis was used to estimate the odds ratios of mortality, LOS, and hospitalization costs of patients admitted on weekends with lower GI bleeding. Weighted analysis using Stata 17 MP was performed. Patient race, insurance status, age, gender and Charlson Comorbidity Index (CCI) were controlled in the regression analyses.

Results: Our study showed that the average mortality was higher for patients with a weekend lower GI bleed who underwent colonoscopy within 2 days of admission (1.16% vs 1.01%) as compared to those who did not, although there was no statistically significant difference (OR 1.29, Cl 0.99-1.68, P=0.052). Average LOS was also significantly shorter for weekend lower GI bleed patients who underwent colonoscopy within 2 days of admission by 2.54 days (OR -2.54, Cl -2.68--2.402785, p< 0.0001%). In addition, average total hospitalization charges was also significantly lower for weekend lower GI bleed patients who underwent colonoscopy within 2 days of admission by $19,038.9 (OR -19038.9, Cl -21297.14- -16780.65, p< 0.0001).

Discussion: Our study demonstrates that patients who are admitted to the hospital for lower GI bleed on a weekend and undergo colonoscopy within 2 days of admission tend to have significantly shorter LOS and lower total hospitalization cost. However there was no mortality difference between patients that underwent colonoscopy within 2 days and those that underwent colonoscopy after 2 days. The findings are limited by the retrospective nature of the study however. Further studies are warranted to support the findings regarding clinical outcomes with respect to procedure timing.


Disclosures:


Christopher Chhoun, DO¹, Fanchen Zhou, MBA², Anudeep Jala, DO¹, Jason John, DO³, Neethi Dasu, DO⁴, Yaser Khalid, DO⁵, C. Jonathan Foster, DO⁶, Lucy Joo, DO⁶. P4183 - Clinical Outcomes in Lower Gastrointestinal Bleeding for Patients Admitted During the Weekend: An Analysis of the National Inpatient Sample 2016-2020, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.