Abstract:
BACKGROUND:Acute nonvariceal upper-GI hemorrhage (NVUGIH) is associated with significant morbidity and mortality. OBJECTIVE:To examine the relationship between hospital volume and outcomes of NVUGIH. DESIGN:A cross-sectional study. SETTING:Participating hospitals from the Nationwide Inpatient Sample 2004. PATIENTS:All discharged patients with a primary discharge diagnosis of NVUGIH based on the International Classification of Diseases, Clinical Modification, ninth edition codes. INTERVENTIONS:Patients were divided into 3 groups based on discharge from hospitals with annual discharge volumes of 1 to 125 (low), 126 to 250 (medium), and >250 (high). MAIN OUTCOME MEASUREMENTS:In-hospital mortality, length of stay, and hospitalization charges. RESULTS:The study included a total of 135,366, 132,746, and 123,007 discharges with NVUGIH occurred from low-volume, medium-volume, and high-volume hospitals, respectively. On multivariate analysis, when adjusting for age, comorbidity, and the presence of complications, patients at high-volume hospitals had significantly lower in-hospital mortality (odds ratio [OR] 0.85 [95% CI, 0.74-0.98]) than patients at low-volume hospitals. Patients at high-volume hospitals were also more likely to undergo upper-GI endoscopy (OR 1.52 [95% CI, 1.36-1.69]) or early endoscopy within 1 day of hospitalization compared with low-volume hospitals (60.5% vs 53.8%, adjusted OR 1.28 [95% CI, 1.02-1.61]). Undergoing endoscopy within day 1 was associated with shorter hospital stays (-1.08 days [95% CI, -1.24 to -0.92 days]) and lower hospitalization charges (-$1958 [95% CI, -$3227 to -$688]). LIMITATIONS:The study was based on an administrative data set. CONCLUSIONS:Higher hospital volume is associated with lower mortality and with higher rates of endoscopy and endoscopic intervention in patients with NVUGIH.
journal_name
Gastrointest Endoscjournal_title
Gastrointestinal endoscopyauthors
Ananthakrishnan AN,McGinley EL,Saeian Kdoi
10.1016/j.gie.2008.12.061subject
Has Abstractpub_date
2009-09-01 00:00:00pages
422-32issue
3eissn
0016-5107issn
1097-6779pii
S0016-5107(08)03179-9journal_volume
70pub_type
杂志文章abstract:BACKGROUND:Common bile duct stenosis occurs in up to 30% of patients with chronic pancreatitis. Most such stenoses are found incidentally during ERCP, but others manifest as obstructive jaundice, recurrent cholangitis, secondary biliary cirrhosis, or choledocholithiasis. Operative drainage has been the main treatment d...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(04)02275-8
更新日期:2004-12-01 00:00:00
abstract:BACKGROUND:Patients with malignant esophagorespiratory fistulas have a poor prognosis. Treatment is palliative and involves restoration of the ability to ingest food and prevention of aspiration by insertion of esophageal or tracheobronchial stents. Because insertion of a single stent may be insufficient for palliation...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2002.119731
更新日期:2002-01-01 00:00:00
abstract::A symptomatic lower esophageal ring generally responds to standard bougienage therapy. However, a subset of patients with a lower esophageal ring defy dilation therapy. We have evaluated the efficacy of electrocautery incision of "defiant" lower esophageal rings, the data of which forms the basis of this report. Seven...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(93)70210-2
更新日期:1993-09-01 00:00:00
abstract:BACKGROUND:Cardiopulmonary unplanned events (CUE) related to conscious sedation constitute a major proportion of GI endoscopy-associated complications. OBJECTIVES:Our purpose was to study the incidence of CUE during GI endoscopy and to determine factors that may predict CUE. DESIGN:Retrospective CORI (Clinical Outcom...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2006.12.040
更新日期:2007-07-01 00:00:00
abstract:BACKGROUND:We assessed the local effects of radiation therapy using intraductal ultrasonography (US) to predict the subsequent patency of metallic stents in bile duct carcinoma. METHODS:Data from 16 patients with extrahepatic-suprapancreatic bile duct carcinoma were prospectively analyzed. Thin-caliber US probes (2.0 ...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章
doi:10.1016/s0016-5107(00)70439-1
更新日期:2000-04-01 00:00:00
abstract:BACKGROUND AND AIMS:Accidental and intentional foreign body ingestions are common and frequently require endoscopic intervention. Sharp metallic objects pose a risk of perforation to the entire GI tract and are often difficult to visualize among food and other matter in the stomach. METHODS:Three patients with histori...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2019.10.023
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:The duodenal-jejunal bypass liner (DJBL) is a new, device-based endoscopic treatment for type 2 diabetes mellitus (T2DM) and obesity. OBJECTIVE:To report serious safety events of subjects treated with the DJBL while offering a simple guideline to mitigate risk. DESIGN:Single-center observational study. SE...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2015.03.1911
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:Recurrent small bowel obstruction caused by postoperative adhesions has traditionally been treated by conventional laparotomy, but laparoscopic management of acute small bowel obstruction has been reported. The aim of this study was to assess the long-term efficacy and clinical outcome of laparoscopic adhesi...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2001.117760
更新日期:2001-10-01 00:00:00
abstract:BACKGROUND:Although conventional endoscopy is a good diagnostic tool to evaluate tumor depth (T staging) in early gastric cancer (EGC), its accuracy has not been determined and no consensus has been reached regarding standard endoscopic criteria. OBJECTIVE:To evaluate the diagnostic accuracy of endoscopic T staging an...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2010.11.053
更新日期:2011-05-01 00:00:00
abstract:BACKGROUNDS AND AIMS:The Japan NBI Expert Team (JNET) classification is the first universal narrow-band imaging magnifying endoscopic classification of colorectal tumors. Considering each type in this classification, the diagnostic ability of Type 2B is the weakest. Generally, clinical behavior is believed to be differ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2017.02.018
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:The treatment of patients with bile duct stones and acute suppurative cholangitis is emergent biliary decompression either by endoscopic sphincterotomy, nasobiliary drainage, or stent insertion. The aim of this retrospective study was to determine whether endoscopic sphincterotomy, in addition to an internal...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/s0016-5107(03)01871-6
更新日期:2003-10-01 00:00:00
abstract:BACKGROUND:Use of colonoscopy is thought to reduce colorectal cancer (CRC) mortality, but its impact at the population level is unclear. OBJECTIVE:To estimate the effect of current colonoscopy use on CRC mortality and its further potential in reducing CRC mortality. DESIGN:Population-level analysis was performed by u...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2010.12.005
更新日期:2011-03-01 00:00:00
abstract:BACKGROUND:Mechanical lithotripsy is used to break large bile duct stones. This study investigated the predictors of unsuccessful mechanical lithotripsy. METHODS:Consecutive patients with bile duct stones underwent endoscopic retrograde cholangiography, sphincterotomy, and basket removal of stones. Mechanical lithotri...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(04)00295-0
更新日期:2004-05-01 00:00:00
abstract:BACKGROUND:Upper endoscopy provides information that can be used to predict complications and to facilitate clinical decisions for patients who have ingested corrosive substances. The role of EUS in corrosive injury has not been investigated. The aim of this study was to determine whether concurrent catheter-probe EUS ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(04)02031-0
更新日期:2004-11-01 00:00:00
abstract::Epinephrine injection is an effective, simple, and economical method of endoscopic hemostasis for bleeding peptic ulcers. We measured catecholamine levels in 18 patients with actively bleeding ulcers (8 gastric ulcers and 10 duodenal ulcers) treated by endoscopic injection. Injection of epinephrine (1:10,000 IU) was g...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(93)70004-8
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND AND AIMS:Optical diagnosis allows for real-time endoscopic assessment of colorectal polyp histology and consists of the resect and discard and diagnose and leave paradigms. This survey assessed patient acceptance of optical diagnosis and their responses to a hypothetical doomsday scenario. METHODS:We conduc...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2016.11.031
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Esophageal metastasis of hepatocellular carcinoma (HCC) is extremely rare; it was not serially followed-up by endoscopy. OBJECTIVE:Our purpose was to report the endoscopic findings according to the progression of esophageal metastatic HCC. DESIGN:Case report. RESULTS:In the review of the cases, submucosal...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,评审
doi:10.1016/j.gie.2008.02.043
更新日期:2008-07-01 00:00:00
abstract::We prospectively evaluated multiple physiologic parameters in 104 consecutive unselected patients undergoing elective colonoscopy. Changes observed during colonoscopy were then correlated with the type of anesthesia and level of sedation, position of the endoscope and presence of looping, existence of comorbid medical...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(90)70916-9
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:Many options are available for palliation of inoperable malignant stenoses of the esophagus. We report our experience with different modalities of endoscopic therapy. METHODS:From 1986 to 1996, we treated 125 patients with dysphagia caused by unresectable malignant tumors with endoscopic therapy. Seventy pa...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(98)70007-0
更新日期:1998-10-01 00:00:00
abstract:BACKGROUND:The hemostatic efficacy of mechanical methods of hemostasis, together with epinephrine injection, was compared with that of epinephrine injection alone in bleeding peptic ulcer. METHODS:Ninety patients with a peptic ulcer with active bleeding or a non-bleeding visible vessel were randomly assigned to underg...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0016-5107(04)01570-6
更新日期:2004-08-01 00:00:00
abstract:BACKGROUND:18-Fluorodeoxyglucose positron emission tomography (PET) is used clinically to detect recurrent colon cancer after surgical resection, but the sensitivity of PET for premalignant colon lesions and early stage colon cancer is not well defined. METHODS:In a prospective study, 45 patients with a total of 58 co...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(04)02775-0
更新日期:2005-03-01 00:00:00
abstract:BACKGROUND:Remote control of capsule endoscopes might allow reliable inspection of the human stomach. OBJECTIVE:To assess the safety and efficacy of manipulation of a modified capsule endoscope with magnetic material (magnetic maneuverable capsule [MMC]) in the human stomach by using a handheld external magnet. DESIG...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章
doi:10.1016/j.gie.2010.08.053
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:A recent American Society for Gastrointestinal Endoscopy Technology Status Evaluation Report recommended comparative studies of water-aided colonoscopy methods to refine the optimal insertion technique. OBJECTIVE:Air insufflation (AI), water immersion (WI), and water exchange (WE) were compared head-to-head...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.gie.2014.07.029
更新日期:2015-03-01 00:00:00
abstract::Thirty patients with upper gastrointestinal bleeding due to a Mallory-Weiss tear were diagnosed by endoscopy. Seventeen patients had stopped bleeding spontaneously, and 13 were actively bleeding when examined. Ten of these 13 were successfully electrocoagulated with cessation of bleeding without morbidity or mortality...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(80)73301-1
更新日期:1980-11-01 00:00:00
abstract:BACKGROUND:A histopathologic diagnosis of metastasis in enlarged mediastinal lymph nodes usually results in non-surgical management. Cytologic specimens obtained by EUS-guided FNA can be used to detect malignancy in posterior mediastinal lymph nodes. The purpose of this study was to determine the rate of thoracic surge...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(04)01709-2
更新日期:2004-09-01 00:00:00
abstract:BACKGROUND AND AIMS:Polyp size ≥ 1 cm triggers more frequent colonoscopic surveillance, yet size is typically based on subjective endoscopic estimates. We sought to compare contemporary assessments of polyp size by endoscopic estimation and pathology measurement. METHODS:Colonoscopy and pathology reports were reviewed...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2015.06.058
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Jackson Pratt (JP) drain fluid bilirubin levels may be assayed in the evaluation of possible bile leaks. Although fluid color and bilirubin level may prompt additional evaluation, there are no reference data available. OBJECTIVE:To assess the JP drain fluid-to-serum bilirubin ratio in patients with document...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2009.08.015
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Colonoscopy is the preferred screening method for colorectal cancer. However, it has a substantial miss rate for colon polyps, and several techniques have been attempted to improve this limitation. Narrow-band imaging (NBI) is a novel technology that enhances the visualization of surface mucosal and vascular...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2007.07.036
更新日期:2008-02-01 00:00:00
abstract::Malignant obstruction of the pancreaticobiliary system is a frequent indication for ERCP. Twenty-five patients with abnormalities suggestive of malignancy were encountered during ERCP at our institution and brush cytology was obtained. Positive cytology specimens were collected in 12 of 20 (60%) cases of malignancy ca...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(90)71024-3
更新日期:1990-05-01 00:00:00
abstract:BACKGROUND:Thermal therapy is the cornerstone of endoscopic treatment of bleeding mucosal lesions of the GI tract. However, there is a 20% failure rate and contact devices may be cumbersome in the treatment of large bleeding areas. A pilot study was conducted to evaluate the safety and efficacy of endoscopic cryotherap...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2003.115
更新日期:2003-03-01 00:00:00