Patel P, Rotundo L, Orosz E, Afridi F, Pyrsopoulos N. Hospital teaching status on the outcomes of patients with esophageal variceal bleeding in the United States. World J Hepatol 2020; 12(6): 288-297 [PMID: 32742571 DOI: 10.4254/wjh.v12.i6.288]
Corresponding Author of This Article
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
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
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/
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Patel P, Rotundo L, Orosz E, Afridi F, Pyrsopoulos N. Hospital teaching status on the outcomes of patients with esophageal variceal bleeding in the United States. World J Hepatol 2020; 12(6): 288-297 [PMID: 32742571 DOI: 10.4254/wjh.v12.i6.288]
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.
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 Processing time: 173 Days and 10.3 Hours
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.
