Observational Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 21, 2015; 21(11): 3344-3350
Published online Mar 21, 2015. doi: 10.3748/wjg.v21.i11.3344
Weekly pattern of emergency room admissions for peptic ulcers: A population-based study
Li-Ting Kao, Ming-Chieh Tsai, Herng-Ching Lin, Femi Pai, Cha-Ze Lee
Li-Ting Kao, Graduate Institute of Life Science, National Defense Medical Center, Taipei 110, Taiwan
Ming-Chieh Tsai, Division of Gastroenterology, Department of Internal Medicine, Cathay General Hospital, Taipei 110, Taiwan
Herng-Ching Lin, Sleep Research Center, Taipei Medical University Hospital, Taipei 110, Taiwan
Femi Pai, School of Medicine, Taipei Medical University, Taipei 110, Taiwan
Cha-Ze Lee, Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei 110, Taiwan
Author contributions: Kao LT and Tsai MC conceived of and designed the study; Lin HC analyzed the data; Lee CZ, Kao LT, Pai F, and Kao LT wrote the manuscript.
Ethics approval: This study was based on de-identified secondary data from the LHID2000 released to the public for research purposes, and thus was exempted from full review by the National Defense Medical Center’s Internal Review Board.
Informed consent: This study retrieved data from an administrative dataset. Therefore, informed consent was not needed.
Conflict-of-interest: The authors declare no conflicts of interest.
Data sharing: The LHID2000, which is open to researchers, is available from the National Health Research Institute of Taiwan (http://nhird.nhri.org.tw/date_01.html); dataset available from nhird@nhri.org.tw.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Cha-Ze Lee, Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, No. 1, Changde St, Taipei 110, Taiwan. czl@ntu.edu.tw
Telephone: +886-2-2736 Fax: +886-2-23789788
Received: November 7, 2014
Peer-review started: November 8, 2014
First decision: November 26, 2014
Revised: December 9, 2014
Accepted: January 8, 2015
Article in press: January 8, 2015
Published online: March 21, 2015
Processing time: 132 Days and 1.9 Hours
Abstract

AIM: To investigate variations in the incidence of peptic ulcers (PUs) in Taiwan by day of the week within age subgroups.

METHODS: Ambulatory care data were retrieved from the Longitudinal Health Insurance Database 2000. There were 7204 subjects ≥ 18 years-old with an emergency room admission claim for the treatment of PUs, resulting in a total of 9234 emergency room visits for PUs between 2009 and 2011. Data was divided into the seven days of the week and an additional variable for holidays. One-way analysis of variance was used to examine associations among the daily mean number of PU emergency room admissions and holidays/weekends/weekdays.

RESULTS: One-way analysis of variance showed that there was a significant difference in emergency room admissions for PUs by the day of the week (P < 0.001), with admission more likely to occur on Sundays or holidays than weekdays within the total and working populations. The weekday patterns of admission were similar for the patients aged 18-64 years and ≥ 65 years of age. Holidays, followed by Sundays, had higher PU admissions than the mean daily PU emergency room admissions. Furthermore, inclusion of only those treated for PUs with hemorrhage or perforation, Sundays and holidays had higher mean emergency room admissions than other days. Inclusion of patients who diagnosed with Helicobacter pylori infection, only holidays had higher mean emergency room admissions than other days. Inclusion of patients who had been prescribed non-steroidal anti-inflammatory drugs (NSAIDs) for over 30 d, Sundays and holidays had higher mean PU ER admissions than other non-holiday weekdays.

CONCLUSION: There is a higher incidence of emergency room admission for PUs on weekends than on weekdays for the total and working populations.

Keywords: Chronology; Epidemiology; Peptic ulcer; Weekly pattern

Core tip: This study used a population-based dataset in Taiwan to investigate the variations in peptic ulcer (PU) incidence by day of the week within subgroups defined by age. We identified 7204 subjects ≥ 18 years-old with an emergency room (ER) admission claim for the treatment of PUs, resulting in a total of 9234 ER visits for PU between 2009 and 2011. There was a higher incidence of PU admission on weekends than on weekdays for the total and working populations. Furthermore, Sundays and holidays had higher mean ER admissions than other days for cases of PUs with hemorrhage or perforation.