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Volume of hospital is important for the prognosis of high-risk patients with nonvariceal upper gastrointestinal bleeding (NVUGIB)

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Author(s)
Jin Woo ChoiSeong Woo JeonJung Gu KwonDong Wook LeeChang Yoon HaKwang Bum ChoByung Ik JangJung Bae ParkYoun Sun Park
Keimyung Author(s)
Cho, Kwang Bum
Department
Dept. of Internal Medicine (내과학)
Journal Title
Surgical Endoscopy
Issued Date
2017
Volume
31
Issue
8
Keyword
Nonvariceal upper gastrointestinal bleedingOutcomesPrognosisVolume of hospital
Abstract
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, ≥60 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 ≥8) 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.
Keimyung Author(s)(Kor)
조광범
Publisher
School of Medicine (의과대학)
Citation
Jin Woo Choi et al. (2017). Volume of hospital is important for the prognosis of high-risk patients with nonvariceal upper gastrointestinal bleeding (NVUGIB). Surgical Endoscopy, 31(8), 3339–3346. doi: 10.1007/s00464-016-5369-9
Type
Article
ISSN
0930-2794
Source
https://link.springer.com/article/10.1007%2Fs00464-016-5369-9
DOI
10.1007/s00464-016-5369-9
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/41581
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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