• Young Hoon Youn, Yong Jin Park, Jae Hak Kim, Tae Joo Jeon, Jae Hee Cho, and Hyojin Park.
• Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 135-720, South Korea. dryoun@yuhs.ac
• World J. Gastroenterol. 2012 Jul 21; 18 (27): 3578-84.

AimTo evaluate whether weekend or nighttime admission affects prognosis of peptic ulcer bleeding despite early endoscopy.MethodsRetrospective data collection from four referral centers, all of which had a formal out-of-hours emergency endoscopy service, even at weekends. A total of 388 patients with bleeding peptic ulcers who were admitted via the emergency room between January 2007 and December 2009 were enrolled. Analyzed parameters included time from patients' arrival until endoscopy, mortality, rebleeding, need for surgery and length of hospital stay.ResultsThe weekday and weekend admission groups comprised 326 and 62 patients, respectively. There were no significant differences in baseline characteristics between the two groups, except for younger age in the weekend group. Most patients (97%) had undergone early endoscopy, which resulted in a low mortality rate regardless of point of presentation (1.8% overall vs 1.6% on the weekend). The only outcome that was worse in the weekend group was a higher rate of rebleeding (12% vs 21%, P = 0.030). However, multivariate analysis revealed nighttime admission and a high Rockall score (≥ 6) as significant independent risk factors for rebleeding, rather than weekend admission.ConclusionEarly endoscopy for peptic ulcer bleeding can prevent the weekend effect, and nighttime admission was identified as a novel risk factor for rebleeding, namely the nighttime effect.

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