Mortality for emergency laparotomy is not affected by the weekend effect: a multicentre study.

Area of Science:

• Surgical Outcomes Research
• Healthcare Quality Improvement
• Emergency Medicine

Background:

• The 'weekend effect' is a known phenomenon causing variations in patient outcomes based on admission day.
• This study specifically investigates the weekend effect in the context of emergency laparotomy patients.

Purpose of the Study:

• To determine if a weekend effect impacts the quality of care and clinical outcomes for patients undergoing emergency laparotomy.
• To compare patient factors, care markers, and outcomes between weekday and weekend emergency laparotomy admissions.

Main Methods:

• Analysis of data from the National Emergency Laparotomy Audit (2014-2017) across four NHS trusts.
• Comparison of patient demographics, quality of care indicators, and patient outcomes between weekday and weekend admission groups.
• Secondary analysis based on the day of surgery.

Main Results:

• 1717 patients were analyzed; no significant differences in age, preoperative lactate, or P-POSSUM scores between groups.
• Key time intervals (admission to review, decision to operate, antibiotics, theatre) and surgeon grades were similar.
• 60-day inpatient mortality was comparable (12.5% weekday vs. 12.8% weekend, P=0.878); median postoperative stay was 12 days for both.

Conclusions:

• The quality of care and clinical outcomes for emergency laparotomy patients admitted on weekends are not significantly different from those admitted on weekdays.
• Findings suggest that the 'weekend effect' does not adversely impact outcomes for this specific surgical patient group.