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Understanding the "Weekend Effect" for Emergency General Surgery.

Richard S Hoehn1, Derek E Go1, Vikrom K Dhar1

  • 1Cincinnati Research in Outcomes and Safety in Surgery (CROSS), Department of Surgery, University of Cincinnati School of Medicine, Cincinnati, OH, USA.

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
|October 1, 2017
PubMed
Summary

Emergency general surgery patients face higher mortality for specific procedures performed on weekends. This weekend effect is linked to increased illness severity and faster surgery times, requiring hospital attention.

Keywords:
Emergency general surgeryMortalityOutcomesPolicyWeekend effect

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Area of Science:

  • Surgical outcomes research
  • Healthcare quality improvement
  • Patient safety in emergency medicine

Background:

  • The

Purpose of the Study:

  • To investigate the

Main Methods:

  • Utilized University HealthSystem Consortium data (2009-2013).
  • Analyzed urgent/emergent general surgery admissions for seven key procedures.
  • Compared patient characteristics and outcomes between weekday and weekend surgeries.

Main Results:

  • Four procedures (laparotomy, lysis of adhesions, partial colectomy, small bowel resection) showed higher weekend mortality.
  • Weekend cases had increased severity of illness and shorter time from admission to surgery.
  • Multivariate analysis confirmed independently higher mortality for these four procedures on weekends.

Conclusions:

  • Identified specific emergency general surgery procedures with increased weekend mortality.
  • Potential causes include acute patient status changes or urgent indications like ischemia/obstruction.
  • Hospitals must address and manage the elevated risks associated with weekend emergency surgeries.