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. 2013 May 28:346:f2424.
doi: 10.1136/bmj.f2424.

Day of week of procedure and 30 day mortality for elective surgery: retrospective analysis of hospital episode statistics

P Aylin  1 , R Alexandrescu, M H Jen, E K Mayer, A Bottle
Affiliations

Day of week of procedure and 30 day mortality for elective surgery: retrospective analysis of hospital episode statistics

P Aylin et al. BMJ. .

Abstract

Objectives: To assess the association between mortality and the day of elective surgical procedure.

Design: Retrospective analysis of national hospital administrative data.

Setting: All acute and specialist English hospitals carrying out elective surgery over three financial years, from 2008-09 to 2010-11.

Participants: Patients undergoing elective surgery in English public hospitals.

Main outcome measure: Death in or out of hospital within 30 days of the procedure.

Results: There were 27,582 deaths within 30 days after 4,133,346 inpatient admissions for elective operating room procedures (overall crude mortality rate 6.7 per 1000). The number of weekday and weekend procedures decreased over the three years (by 4.5% and 26.8%, respectively). The adjusted odds of death were 44% and 82% higher, respectively, if the procedures were carried out on Friday (odds ratio 1.44, 95% confidence interval 1.39 to 1.50) or a weekend (1.82, 1.71 to 1.94) compared with Monday.

Conclusions: The study suggests a higher risk of death for patients who have elective surgical procedures carried out later in the working week and at the weekend.

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Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare that Dr Foster Unit at Imperial is principally funded via a research grant by Dr Foster Intelligence, an independent healthcare information company and joint venture with the Department of Health.

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Adjusted odds of death and 95% confidence intervals by day of procedure in English hospitals for 2008-9 to 2010-11
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