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Background <p>Dieulafoy’s lesion (DL) is an uncommon cause of nonvariceal upper gastrointestinal bleeding (NVUGIB). The weekend effect refers to the phenomenon where patients admitted on weekends experience clinically poorer outcomes. This study aimed to explore the weekend effect on clinical outcomes after endoscopic hemostasis for DL in the upper gastrointestinal tract, and whether this relationship was mediated by the experience of the endoscopist.</p> Methods <p>This retrospective analysis included patients with DL of the upper gastrointestinal tract who underwent standard endoscopic hemostasis treatment between April 2007 and June 2025. Univariate and multivariate analysis, propensity score matching (PSM), and mediation analysis were used to explore the relationships between the weekend effect, the experience of the endoscopist and the rebleeding rate of DL.</p> Results <p>A total of 283 patients were included in this study, consisting of 212 patients in the weekday admission group and 71 patients in the weekend admission group. Multivariate analysis showed weekend admission was an independent risk factor for rebleeding of DL. After matching, the baseline characteristics of 64 patients in the weekday admission group and 64 patients in the weekend admission group were balanced. The rebleeding rate of DL in the weekend admission group was significantly higher than that in the weekday admission group (31.3% vs. 10.9%, <i>P</i> = 0.005). Patients admitted on weekends were more likely to be treated by less-experienced endoscopists compared to those admitted on weekdays (48.4% vs. 25.0%, <i>P</i> = 0.006). Moreover, a significant indirect effect of the weekend effect on rebleeding of DL through less-experienced endoscopists was found, and the proportions mediated were 17.42%.</p> Conclusion <p>The weekend effect was significantly associated with the higher rebleeding rate in patients with DL of the upper gastrointestinal tract, and less-experienced endoscopists on weekends might be playing a mediating role in this relationship.</p>

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Experience of the endoscopist mediates the association between weekend effect with rebleeding after endoscopic treatment for Dieulafoy’s lesion

  • 期刊论文

  • 发表日期：

    2025年11月21日

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  • Jiayu Qiu,
  • Yanhong Xia,
  • Ruiying Ding,
  • Qingping Ouyang,
  • Liping Wang,
  • Yang Huang,
  • Sihai Chen,
  • Zhenzhen Yang,
  • Xu Shu,
  • Xiaolin Pan,
  • Yanxia Zhang

摘要

Background

Dieulafoy’s lesion (DL) is an uncommon cause of nonvariceal upper gastrointestinal bleeding (NVUGIB). The weekend effect refers to the phenomenon where patients admitted on weekends experience clinically poorer outcomes. This study aimed to explore the weekend effect on clinical outcomes after endoscopic hemostasis for DL in the upper gastrointestinal tract, and whether this relationship was mediated by the experience of the endoscopist.

Methods

This retrospective analysis included patients with DL of the upper gastrointestinal tract who underwent standard endoscopic hemostasis treatment between April 2007 and June 2025. Univariate and multivariate analysis, propensity score matching (PSM), and mediation analysis were used to explore the relationships between the weekend effect, the experience of the endoscopist and the rebleeding rate of DL.

Results

A total of 283 patients were included in this study, consisting of 212 patients in the weekday admission group and 71 patients in the weekend admission group. Multivariate analysis showed weekend admission was an independent risk factor for rebleeding of DL. After matching, the baseline characteristics of 64 patients in the weekday admission group and 64 patients in the weekend admission group were balanced. The rebleeding rate of DL in the weekend admission group was significantly higher than that in the weekday admission group (31.3% vs. 10.9%, P = 0.005). Patients admitted on weekends were more likely to be treated by less-experienced endoscopists compared to those admitted on weekdays (48.4% vs. 25.0%, P = 0.006). Moreover, a significant indirect effect of the weekend effect on rebleeding of DL through less-experienced endoscopists was found, and the proportions mediated were 17.42%.

Conclusion

The weekend effect was significantly associated with the higher rebleeding rate in patients with DL of the upper gastrointestinal tract, and less-experienced endoscopists on weekends might be playing a mediating role in this relationship.