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Journal of Gastroenterology

, Volume 51, Issue 11, pp 1063–1072 | Cite as

No weekend effect on outcomes of severe acute pancreatitis in Japan: data from the diagnosis procedure combination database

  • Tsuyoshi Hamada
  • Hideo Yasunaga
  • Yousuke Nakai
  • Hiroyuki Isayama
  • Hiroki Matsui
  • Kiyohide Fushimi
  • Kazuhiko Koike
Original Article—Liver, Pancreas, and Biliary Tract

Abstract

Background

In the early phase of severe acute pancreatitis, timely multidisciplinary management is required to reduce mortality. The aim of this observational study was to evaluate the impact of weekend hospital admission on outcomes using population-based data in Japan.

Methods

Data on adult patients (≥20 years) with severe acute pancreatitis were extracted from a nationwide Japanese administrative database covering over 1000 hospitals. In-hospital mortality, length of stay, and total costs were compared between weekend and weekday admissions, with adjustment for disease severity according to the current Japanese severity scoring system for acute pancreatitis, and other potential risk factors.

Results

In total, 8328 patients hospitalized during the study period 2010–2013 were analyzed (2242 admitted at weekends and 6086 on weekdays). In-hospital mortality rates were not significantly different: 5.9 vs. 5.4 % for weekend and weekday admissions, respectively (multivariate-adjusted odds ratio, 1.06; 95 % confidence interval, 0.83–1.35). The impact of weekend admission was not significant either for length of hospitalization (median, 18 vs. 19 days) and total costs (median, 6161 vs. 6233 US dollars) (both p > 0.19 in multivariate-adjusted linear regression). The rates of, and time to, specific treatments were also similar between patients with weekend and weekday admissions.

Conclusions

A weekend effect in severe acute pancreatitis admissions was not evident. Adjustments to weekend staffing and selective hospital referral of patients admitted at weekends are not indicated for severe acute pancreatitis in current clinical practice in Japan.

Keywords

Acute disease Database Mortality Prognosis Severity of illness index 

Notes

Acknowledgments

This work was supported by Grants for Research on Policy Planning and Evaluation from the Ministry of Health, Labour and Welfare, Japan (Grant Numbers: H27-Policy-Designated-009 and H27-Policy-Strategy-011).

Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest to disclose.

Supplementary material

535_2016_1179_MOESM1_ESM.docx (43 kb)
Supplementary material 1 (DOCX 43 kb)

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Copyright information

© Japanese Society of Gastroenterology 2016

Authors and Affiliations

  • Tsuyoshi Hamada
    • 1
  • Hideo Yasunaga
    • 2
  • Yousuke Nakai
    • 1
  • Hiroyuki Isayama
    • 1
  • Hiroki Matsui
    • 2
  • Kiyohide Fushimi
    • 3
  • Kazuhiko Koike
    • 1
  1. 1.Department of Gastroenterology, Graduate School of MedicineThe University of TokyoTokyoJapan
  2. 2.Department of Clinical Epidemiology and Health Economics, School of Public HealthThe University of TokyoTokyoJapan
  3. 3.Department of Health Care InformaticsTokyo Medical and Dental UniversityTokyoJapan

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