Always on a Friday? Time pattern of referral for spinal cord compression

For patients with spinal cord compression, radiotherapy should be initiated as soon as possible to optimize the chances for restoration of neurological function. The speed of referral in the region of our radiotherapy institution with nine general hospitals was analysed based on a tumour and treatment-related registry. From January 1987 to December 1997, 443 patients were treated. All patients were seen and treated on the day of referral. Significantly more referrals took place on Friday, 30%, compared with 12% on Monday, 17% on Tuesday, 15% on Wednesday, 20% on Thursday, 5% on Saturday and 1% on Sunday (p < 0.002). This difference was the same for patients whether they were formerly treated in our institution (n = 242) or not (n = 201). No significant difference was found between different categories of patients (p = 0.28). These data are discussed with the referring physicians to encourage speed of diagnosis and referral.