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Weekend effect in emergency laparotomy: a propensity score-matched analysis
Amy Sylivris1, Dhruvesh M Ramson1,2,3, Jahan C Penny-Dimri1
1Department of Surgery, Monash University, Melbourne, Victoria, Australia.
ANZ Journal of Surgery
|July 7, 2023
Summary
The weekend effect, a disparity in patient care, was investigated for emergency laparotomy (EL) patients in New Zealand. Modern care practices appear to eliminate this weekend effect, showing comparable outcomes for weekend and weekday EL patients.
Area of Science:
- Medical research
- Surgical outcomes
- Healthcare disparities
Background:
- The 'weekend effect' describes variations in patient care and outcomes between weekdays and weekends.
- This study investigates the presence of the weekend effect in Aotearoa New Zealand (AoNZ).
- Focus is on patients undergoing emergency laparotomy (EL), considering recent management advancements.
Purpose of the Study:
- To determine if the weekend effect impacts emergency laparotomy (EL) patients in AoNZ.
- To assess if modern perioperative care mitigates potential weekend disparities.
- To compare outcomes of weekend versus weekday EL procedures.
Main Methods:
- A cohort study design was employed across five hospitals.
- Outcomes of weekend and weekday acute EL patients were compared.
- Propensity-score matching was utilized to control for confounding patient factors.
Main Results:
- 132 of 487 included patients underwent EL during the weekend.
- No statistically significant difference in outcomes was observed between weekend and weekday EL.
- Mortality rates were comparable between the weekday and weekend cohorts (P=0.464).
Conclusions:
- Modern perioperative care in New Zealand appears to negate the 'weekend effect'.
- Outcomes for emergency laparotomy patients are consistent regardless of admission day.
- This suggests a high standard of care is maintained throughout the week.
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