The effect of off-hours hospital admission on mortality and clinical outcomes for patients with upper gastrointestinal hemorrhage: A systematic review and meta-analysis of 20 cohorts
Publication in refereed journal

Times Cited
Altmetrics Information

Other information

The objective of this article is to evaluate the relationship between off-hours hospital admission (weekends, public holidays or nighttime) and mortality for upper gastrointestinal hemorrhage (UGIH).


Medline, Embase, Scopus, and the Chinese Biomedical Literature were searched through December 2016 to identify eligible records for inclusion in this meta-analysis. A random-effects model was applied.


Twenty cohort studies were included for analysis. Patients with UGIH who were admitted during off-hours had a significantly higher mortality and were less likely to receive endoscopy within 24 hours of admission. In comparison to variceal cases, patients with nonvariceal bleeding showed a higher mortality when admitted during off-hours. However, for studies conducted in hospitals that provided endoscopy outside normal hours, off-hours admission was not associated with an increased risk of mortality.


Our study showed a higher mortality for patients with nonvariceal UGIH who were admitted during off-hours, while this effect might be offset in hospitals with a formal out-of-hours endoscopy on-call rotation.
Acceptance Date25/08/2017
All Author(s) ListXian Feng Xia, Philip Wai Yan Chiu, Kelvin Kam Fai Tsoi, Francis Ka Leung Chan, Joseph Jao Yiu Sung, James Yun Wong Lau
Journal nameUnited European Gastroenterology Journal
Volume Number6
Issue Number3
Pages367 - 381
LanguagesEnglish-United Kingdom
KeywordsUpper gastrointestinal hemorrhage, off-hours, meta-analysis

Last updated on 2021-08-05 at 00:29