Volume of hospital is important for the prognosis of high-risk patients with nonvariceal upper gastrointestinal bleeding (NVUGIB)
- Authors
- Choi, Jin Woo; Jeon, Seong Woo; Kwon, Jung Gu; Lee, Dong Wook; Ha, Chang Yoon; Cho, Kwang Bum; Jang, Byung Ik; Park, Jung Bae; Park, Youn Sun
- Issue Date
- Aug-2017
- Publisher
- Springer Verlag
- Keywords
- Nonvariceal upper gastrointestinal bleeding; Volume of hospital; Outcomes; Prognosis
- Citation
- Surgical Endoscopy, v.31, no.8, pp 3339 - 3346
- Pages
- 8
- Journal Title
- Surgical Endoscopy
- Volume
- 31
- Number
- 8
- Start Page
- 3339
- End Page
- 3346
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/7341
- DOI
- 10.1007/s00464-016-5369-9
- ISSN
- 0930-2794
1432-2218
- Abstract
- Background and aim Nonvariceal upper gastrointestinal bleeding (NVUGIB) is a potentially life-threatening hospital emergency requiring hemodynamic stabilization and resuscitation. This study is carried out to determine whether hospital volume can influence outcome in patients with NVUGIB. Method This is a retrospective study with a prospective cohort database (KCT 0000514. cris.nih.go.kr). Eight teaching hospitals were divided into two different groups: high-volume centers (HVC, C60 NVUGIB patients/year, four clinics) and low-volume centers (LVC, <60 NVUGIB patients/year, four clinics). Baseline characteristics of patients, risk stratification, and outcomes between hospitals of different volumes were compared. From February 2011 to December 2013, a total of 1584 NVUGIB patients enrolled in eight clinics were retrospectively reviewed. The main outcome measurements consisted of continuous bleeding after treatment, re-bleeding, necessity for surgical/other retreatments, and death within 30 days. Results Similar baseline characters for patients were observed in both groups. There was a significant difference in the incidence of poor outcome between the HVC and LVC groups (9.06 vs. 13.69%, P = 0.014). The incidence rate of poor outcome in high-risk patients (Rockall score C8) in HVC was lower than that in high-risk patients in LVC (16.07 vs. 26.92%, P = 0.048); however, there was no significant difference in poor outcome in the lower-risk patients in either group (8.72 vs. 10.42%, P = 0.370). Conclusions Significant correlation between hospital volume and outcome in NVUGIB patients was observed. Referral to HVC for the management of high-risk NVUGIB patients should be considered in clinical practice.
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Collections - College of Medicine > Department of Internal Medicine > 1. Journal Articles
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