BACKGROUND: The "weekend effect" is defined as increased morbidity and mortality for patients admitted on weekends compared with weekdays. It has been observed for several diseases, including myocardial infarction and renal insufficiency; however, it has not yet been investigated for laparoscopic appendectomy in acute appendicitis-one of the most prevalent surgical diagnoses. METHODS: The present study is based on the Nationwide Inpatient Sample (NIS) from 1999 to 2008. The following outcomes were compared between patients undergoing laparoscopic appendectomy for acute appendicitis admitted on weekdays versus weekends: severity of appendicitis, intraoperative and postoperative complications, conversion rate, in-hospital mortality, and length of hospital stay. Unadjusted and risk-adjusted generalized linear regression analyses were performed. RESULTS: Overall, 151,774 patients were included, mean age was 39.6 years, 52.6% (n = 79,801) were male, and 25.3% (n = 38,317) were admitted on weekends. After risk adjustment, the conversion rate was lower [odds ratio (OR): 0.94, p = 0.004, number needed to harm (NNH): 244], whereas pulmonary complications (OR: 1.12, p = 0.028, NNH: 649) and reoperations (OR: 1.21, p = 0.013, NNH: 1,028) were slightly higher on weekends than on weekdays. Overall postoperative complications (OR: 1.03, p = 0.24), mortality (OR: 1.37, p = 0.075) and length of hospital stay (mean on weekday: 2.00 days, weekends: 2.01 days, p = 0.29) were not statistically different. CONCLUSIONS: The present investigation provides evidence that no clinically significant "weekend effect" for patients undergoing laparoscopic appendectomy exists. Therefore, hospital or staffing policy changes are not justified based on the findings from this large national study.
BACKGROUND: The "weekend effect" is defined as increased morbidity and mortality for patients admitted on weekends compared with weekdays. It has been observed for several diseases, including myocardial infarction and renal insufficiency; however, it has not yet been investigated for laparoscopic appendectomy in acute appendicitis-one of the most prevalent surgical diagnoses. METHODS: The present study is based on the Nationwide Inpatient Sample (NIS) from 1999 to 2008. The following outcomes were compared between patients undergoing laparoscopic appendectomy for acute appendicitis admitted on weekdays versus weekends: severity of appendicitis, intraoperative and postoperative complications, conversion rate, in-hospital mortality, and length of hospital stay. Unadjusted and risk-adjusted generalized linear regression analyses were performed. RESULTS: Overall, 151,774 patients were included, mean age was 39.6 years, 52.6% (n = 79,801) were male, and 25.3% (n = 38,317) were admitted on weekends. After risk adjustment, the conversion rate was lower [odds ratio (OR): 0.94, p = 0.004, number needed to harm (NNH): 244], whereas pulmonary complications (OR: 1.12, p = 0.028, NNH: 649) and reoperations (OR: 1.21, p = 0.013, NNH: 1,028) were slightly higher on weekends than on weekdays. Overall postoperative complications (OR: 1.03, p = 0.24), mortality (OR: 1.37, p = 0.075) and length of hospital stay (mean on weekday: 2.00 days, weekends: 2.01 days, p = 0.29) were not statistically different. CONCLUSIONS: The present investigation provides evidence that no clinically significant "weekend effect" for patients undergoing laparoscopic appendectomy exists. Therefore, hospital or staffing policy changes are not justified based on the findings from this large national study.
Authors: Margaret Jean Hall; Carol J DeFrances; Sonja N Williams; Aleksandr Golosinskiy; Alexander Schwartzman Journal: Natl Health Stat Report Date: 2010-10-26
Authors: Ulrich Guller; Sheleika Hervey; Harriett Purves; Lawrence H Muhlbaier; Eric D Peterson; Steve Eubanks; Ricardo Pietrobon Journal: Ann Surg Date: 2004-01 Impact factor: 12.969
Authors: David J Magid; Yongfei Wang; Jeph Herrin; Robert L McNamara; Elizabeth H Bradley; Jeptha P Curtis; Charles V Pollack; William J French; Martha E Blaney; Harlan M Krumholz Journal: JAMA Date: 2005-08-17 Impact factor: 56.272
Authors: William J Kostis; Kitaw Demissie; Stephen W Marcella; Yu-Hsuan Shao; Alan C Wilson; Abel E Moreyra Journal: N Engl J Med Date: 2007-03-15 Impact factor: 91.245
Authors: Matthew A C Zapf; Anai N Kothari; Talar Markossian; Gopal N Gupta; Robert H Blackwell; Phillip Y Wai; Cynthia E Weber; Joseph Driver; Paul C Kuo Journal: Surgery Date: 2015-05-23 Impact factor: 3.982
Authors: Shelly Choo; Dominic Papandria; Seth D Goldstein; Henry Perry; Afua A J Hesse; Francis Abatanga; Fizan Abdullah Journal: World J Surg Date: 2013-11 Impact factor: 3.352
Authors: Katherine W Gonzalez; Brian G A Dalton; Katrina L Weaver; Ashley K Sherman; Shawn D St Peter; Charles L Snyder Journal: Pediatr Surg Int Date: 2016-05-24 Impact factor: 1.827
Authors: Elisabeth M L de Wijkerslooth; Jay M Bakas; Joost van Rosmalen; Anne Loes van den Boom; Bas P L Wijnhoven Journal: Int J Colorectal Dis Date: 2021-02-11 Impact factor: 2.571
Authors: Stephen A Smith; Jennifer M Yamamoto; Derek J Roberts; Karen L Tang; Paul E Ronksley; Elijah Dixon; W Donald Buie; Matthew T James Journal: Med Care Date: 2018-02 Impact factor: 2.983