A 'weekend effect' in operative emergency general surgery

Am J Surg. 2020 Jul;220(1):237-239. doi: 10.1016/j.amjsurg.2019.11.024. Epub 2019 Nov 13.

Abstract

Background: Evidence of a "weekend effect" is limited in emergency general surgery (EGS). We hypothesized that there are increased rates of complications, death, and failure-to-rescue (FTR) in patients undergoing weekend EGS operations.

Methods: National Inpatient Sample (NIS) data, January 2014-September 2015 were used. Operative EGS patients were identified by ICD-9 procedure code and timing to operation. Complications were defined by ICD-9 code. We performed survey-weighted multivariable regression analyses.

Results: Of 438,110 EGS patients, 103,450 underwent weekend operation. There was no association between weekend operation and FTR (OR 1.17; 95%CI 0.95-1.45) or complications (OR 1.04; 95%CI 0.97-1.13). There was a weekend effect on mortality (OR 1.22; 95%CI 1.02-1.46) and an interactive effect between weekend operation and teaching status on complications (teaching OR 1.22; 95%CI 1.15-1.29; interaction OR 1.13; 95%CI 1.03-1.25).

Conclusions: There is evidence for a "weekend effect" on mortality, but not complications or FTR, in this cohort.

Keywords: Emergency general surgery; Failure-to-rescue; Metrics; Quality improvement.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Emergencies*
  • Emergency Service, Hospital / statistics & numerical data*
  • Hospital Mortality
  • Humans
  • Morbidity / trends
  • Postoperative Complications / epidemiology*
  • Retrospective Studies
  • Risk Assessment / methods*
  • Surgical Procedures, Operative / adverse effects*
  • Survival Rate / trends
  • Time Factors
  • United States / epidemiology