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Is there a 'weekend effect' in elective lower limb arthroplasty?
M Higgins1, J Nightingale1, K Sehat1
1Trauma and Orthopaedics, Nottingham City Hospitals NHS Trust, Nottingham, UK.
Annals of the Royal College of Surgeons of England
|February 9, 2021
Summary
This study found no evidence of a weekend effect on hospital stay for elective joint replacement surgery. Patient age, ASA grade, and gender were associated with longer lengths of stay.
Area of Science:
- Orthopedic Surgery
- Health Services Research
Background:
- The 'weekend effect' describes a potential decline in patient care quality on weekends.
- Investigating this effect is crucial for optimizing hospital resource allocation and patient outcomes.
Purpose of the Study:
- To determine if the day of surgery impacts hospital length of stay for elective lower limb joint arthroplasty.
- To identify patient-specific factors influencing length of stay in these procedures.
Main Methods:
- Analysis of a prospectively collected database of elective primary total knee and hip arthroplasty patients.
- Utilized multiple linear regression to analyze patient and clinical variables against length of hospital stay.
Main Results:
- No association was found between the day of surgery and length of stay for knee or hip replacements.
- Increasing age, higher American Society of Anesthesiologists (ASA) grade, and male gender were linked to longer hospital stays.
Conclusions:
- The study did not identify a 'weekend effect' in elective joint arthroplasty at the studied NHS hospital.
- Focusing resources on high-risk patient groups (older, higher ASA, male) may reduce overall length of stay.
- Overall length of stay decreased over time, indicating successful management of weekend services.
