Elective surgery prone to a significant "weekend effect"

When elective surgery is performed in the latter half of the week — i.e. approaching the weekend — postoperative death rates tend to rise, according to a study published in Medical Care.

Researchers searched PubMed, EMBASE and references of relevant articles for studies that compared postoperative mortality according to the day of the week of surgery for elective operations or according to weekend versus weekday admission for urgent/emergent operations.

They found 4,027 citations identified, 10 elective surgery studies with more than 6.6 million patients and 19 urgent/emergent surgery studies with more than 1.4 patients.

The pooled odds of mortality postsurgery rose in a graded manner as the day of the week of surgery approached the weekend:

• Monday: Odds ratio equaled 1
• Tuesday: Odds ratio equaled 1.04
• Wednesday: Odds ratio equaled 1.08
• Thursday: Odds ratio equaled 1.12
• Friday: Odds ratio equaled 1.24

Additionally, mortality was higher among patients who underwent urgent/emergent surgery after admission on the weekend as compared to admission on weekdays.

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