Retrospective Cohort Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jun 27, 2020; 12(6): 288-297
Published online Jun 27, 2020. doi: 10.4254/wjh.v12.i6.288
Hospital teaching status on the outcomes of patients with esophageal variceal bleeding in the United States
Pavan Patel, Laura Rotundo, Evan Orosz, Faiz Afridi, Nikolaos Pyrsopoulos
Pavan Patel, Faiz Afridi, Nikolaos Pyrsopoulos, Division of Gastroenterology and Hepatology, Rutgers - New Jersey Medical School, Newark, NJ 07101-1709, United States
Laura Rotundo, Evan Orosz, Department of Medicine, Rutgers - New Jersey Medical School, Newark, NJ 07101-1709, United States
Author contributions: Patel P provided conception and design of the study, acquisition and analysis of data, and drafting of the manuscript; Rotundo L, Afridi F and Orosz E drafted the manuscript; Pyrsopoulos N contributed to the manuscript by providing revision and oversight of its writing.
Institutional review board statement: This study did not require IRB approval due since the database is representative of nationally acquired data.
Informed consent statement: Due to the retrospective nature of this study as well as the using of a national database no human information was made available to authors. Therefore, informed consent was not needed to write this manuscript.
Conflict-of-interest statement: Authors declare no conflict of interest for this article.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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/
Corresponding author: Nikolaos Pyrsopoulos, FACP, MD, PhD, Chief Doctor, Professor, Division of Gastroenterology and Hepatology, Rutgers – New Jersey Medical School, 185 S. Orange Avenue, MSB H-535, Newark, NJ 07101-1709, United States. pyrsopni@njms.rutgers.edu
Received: January 6, 2020
Peer-review started: January 6, 2020
First decision: March 15, 2020
Revised: April 10, 2020
Accepted: May 14, 2020
Article in press: May 14, 2020
Published online: June 27, 2020
ARTICLE HIGHLIGHTS
Research background

Acute variceal bleeding is a major complication of portal hypertension and is a leading cause of death in patients with cirrhosis. There is limited data on the outcomes of patients with esophageal variceal bleeding in teaching versus nonteaching hospitals.

Research motivation

To understand if the teaching status of a hospital has better or poorer outcomes in management of patients with variceal bleeding.

Research objectives

Compare outcomes of mortality, length of stay and cost of hospitalization amongst patients presenting with acute variceal bleeding in cohorts of teaching vs nonteaching hospitals.

Research methods

We looked at retrospective data from a large national database of patients that presented with acute variceal bleeding.

Research results

The mortality, length of stay and cost of hospitalization was higher amongst patients with acute variceal bleeding that presented to a teaching hospital. When controlling for comorbidities and hospital characteristics this remained statistically significant.

Research conclusions

Teaching hospitals did worse in outcomes for patients with variceal bleeding when compared to non-teaching hospitals. Further details may need to be deciphered as to what could contribute to these findings.

Research perspectives

Prospective studies at teaching and non-teaching institutions when controlling for severity of illness can shed light on whether teaching hospitals need to improve their delivery of care for patients with variceal bleeding.