Weekend Admission for Acute Cholangitis Does Not Adversely Impact Clinical or Endoscopic Outcomes

@article{Tabibian2015WeekendAF,
  title={Weekend Admission for Acute Cholangitis Does Not Adversely Impact Clinical or Endoscopic Outcomes},
  author={James H. Tabibian and Ju Dong Yang and Todd H. Baron and Sunanda V Kane and Felicity Enders and Christopher J. Gostout},
  journal={Digestive Diseases and Sciences},
  year={2015},
  volume={61},
  pages={53-61}
}
BackgroundAcute cholangitis (AC) requires prompt diagnosis and treatment for optimal management.AimsTo examine whether a putative “weekend effect” impact outcomes of patients hospitalized for AC.MethodsWe conducted a retrospective study of patients admitted with AC between 2009 and 2012. After excluding those not meeting Tokyo consensus criteria for AC, the cohort was categorized into weekend (Saturday–Sunday) and weekday (Monday–Friday) hospital admission and endoscopic retrograde… 
Association of Admission Laboratory Values and the Timing of Endoscopic Retrograde Cholangiopancreatography With Clinical Outcomes in Acute Cholangitis.
TLDR
In the validation cohort, timing of endoscopic retrograde cholangiopancreatography was not significantly different between those with and without an adverse outcome, even when stratified by AC severity, and consideration should be given to include these criteria in the Tokyo Guidelines severity assessment.
Association of Timing of Biliary Drainage with Clinical Outcomes in Severe Acute Cholangitis: A Retrospective Cohort Study
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In severe acute cholangitis patients, delay in BD increased in-hospital LOS and BD after 48 hours was associated with longer ICU LOS, yet, BD within 24 hours did not significantly reduce the mortality nor shortened the ICu LOS.
No Association of Timing of Endoscopic Biliary Drainage with Clinical Outcomes in Patients with Non-severe Acute Cholangitis
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Elective biliary drainage was not associated with worse clinical outcomes of non- severe acute cholangitis as compared to urgent drainage, and further investigation is warranted to justify the elective drainage for non-severe cholangsitis.
ASGE guideline on the management of cholangitis.
A Statistically Significant Reduction in Length of Stay and Hospital Costs with Equivalent Quality of Care Metrics for ERCPs Performed During the Weekend Versus Postponed to Weekdays: A 6-Year Study of 533 ERCPs at Four Teaching Hospitals
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Performing ERCPs during weekends significantly reduced LOS, hospital costs, and hospital charges compared to postponing ERCP to WD and resulted in net hospital profits, without impairing quality of medical care.
Identifying and Treating Ascending Cholangitis: A case report and review of literature.
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All patients with suspected ascending cholangitis should undergo appropriate fluid resuscitation, be given broad spectrum antibiotics to cover the likely enteric pathogens, and closely monitored for worsening in their clinical condition.
Non-emergent Weekend ERCP: It Makes Sense—Now, Make It Work
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Reducing LOS decreases expenses for the patient and the payer, reduces costs for the hospital, and improves access to hospital beds for patients; the latter benefits the hospital financially and improves their ability to provide more expedient service for the next patient in need of care.
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