Blog | Tuesday, June 4, 2013

QD: News Every Day--Now there's a 'weekday effect' for hospital mortality, too


There may be a higher risk of death for patients who have elective surgical procedures carried out later in the working week compared to Monday, as well as the more famous "weekend effect," a retrospective study found.

To assess the association between mortality and the day of elective surgical procedure, researchers conducted a retrospective analysis of national hospital administrative data from all acute and specialist English hospitals.

Results appeared at BMJ.

There were more than 27,500 deaths within 30 days after more than 4.1 million elective surgeries (overall crude mortality rate 6.7 per 1,000). The adjusted odds of death were 44% for procedures done on a Friday (95% confidence interval [CI], 1.39 to 1.50) and 82% for procedures done on a weekend (95% CI, 1.71 to 1.94) compared with Monday.

There was also an effect for mortality within two days of surgery. Adjusted odds of death was 42% (95% CI, 1.26 to 1.60) for procedures done on Friday and 167% for those done on the weekend (95% CI, 2.30 to 3.09) compared with Monday.

Authors wrote, "The reasons behind this remain unknown, but we know that serious complications are more likely to occur within the first 48 hours after an operation, and a failure to rescue the patient could be due to well-known issues relating to reduced and/or locum staffing (expressed as number and level of experience) and poorer availability of services over a weekend."