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Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
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Outcomes of non-elective coronary artery bypass grafting performed on weekends

Jared P Beller1, William Z Chancellor1, J Hunter Mehaffey1

  • 1Division of Cardiac Surgery, Department of Surgery, University of Virginia, Charlottesville, VA, USA.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|January 28, 2020
PubMed

Insights

Weekend surgery for coronary artery bypass grafting (CABG) did not increase patient mortality. However, patients undergoing weekend CABG faced higher risks of major morbidity, warranting further investigation into the causes.

Area of Science:

  • Cardiovascular Surgery
  • Health Services Research
  • Surgical Outcomes

Background:

  • A
  • weekend effect
  • has been observed in surgical patients and those with acute myocardial infarction (MI), suggesting increased mortality.
  • The existence of a similar phenomenon in coronary artery bypass grafting (CABG) procedures was hypothesized.

Purpose of the Study:

  • To investigate whether a
  • weekend effect
  • impacts mortality and morbidity in patients undergoing non-elective isolated CABG.

Main Methods:

  • Analysis of a multicentre regional Society of Thoracic Surgeons database for non-elective isolated CABG patients from 2011-2017.
  • Patients were stratified into weekend versus weekday operation groups and analyzed by specific day of the week.
  • Risk-adjusted analyses were performed to assess the impact of weekend surgery on mortality and morbidity.

Main Results:

  • Weekend CABG operations were more likely to be emergencies and associated with MI (70.0% vs 51.2%).
  • Risk-adjusted analyses showed no increased odds of mortality for weekend CABG (OR 1.07, P=0.811).
  • A significant increase in major morbidity was observed for weekend operations (OR 1.37, P=0.034), with morbidity increasing from Tuesday through the weekend.

Conclusions:

  • There is no independent effect of weekend surgery on mortality for CABG patients, despite higher baseline risk.
  • Patients undergoing weekend CABG face an elevated risk of major morbidity.
  • The underlying causes for increased weekend morbidity require further investigation.
Abstract

Keywords:
Coronary artery diseasePerioperative careQuality careWeekend effect

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