Justin S Hatchimonji1, Elinore J Kaufman2, Catherine E Sharoky3, Lucy W Ma4, Daniel N Holena2. 1. Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA. Electronic address: justin.hatchimonji@uphs.upenn.edu. 2. Division of Traumatology, Surgical Critical Care and Emergency Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA. 3. Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA. 4. College of Arts and Sciences, University of Pennsylvania, Philadelphia, PA, USA.
Abstract
BACKGROUND: Evidence of a "weekend effect" is limited in emergency general surgery (EGS). We hypothesized that there are increased rates of complications, death, and failure-to-rescue (FTR) in patients undergoing weekend EGS operations. METHODS: National Inpatient Sample (NIS) data, January 2014-September 2015 were used. Operative EGS patients were identified by ICD-9 procedure code and timing to operation. Complications were defined by ICD-9 code. We performed survey-weighted multivariable regression analyses. RESULTS: Of 438,110 EGS patients, 103,450 underwent weekend operation. There was no association between weekend operation and FTR (OR 1.17; 95%CI 0.95-1.45) or complications (OR 1.04; 95%CI 0.97-1.13). There was a weekend effect on mortality (OR 1.22; 95%CI 1.02-1.46) and an interactive effect between weekend operation and teaching status on complications (teaching OR 1.22; 95%CI 1.15-1.29; interaction OR 1.13; 95%CI 1.03-1.25). CONCLUSIONS: There is evidence for a "weekend effect" on mortality, but not complications or FTR, in this cohort.
BACKGROUND: Evidence of a "weekend effect" is limited in emergency general surgery (EGS). We hypothesized that there are increased rates of complications, death, and failure-to-rescue (FTR) in patients undergoing weekend EGS operations. METHODS: National Inpatient Sample (NIS) data, January 2014-September 2015 were used. Operative EGS patients were identified by ICD-9 procedure code and timing to operation. Complications were defined by ICD-9 code. We performed survey-weighted multivariable regression analyses. RESULTS: Of 438,110 EGS patients, 103,450 underwent weekend operation. There was no association between weekend operation and FTR (OR 1.17; 95%CI 0.95-1.45) or complications (OR 1.04; 95%CI 0.97-1.13). There was a weekend effect on mortality (OR 1.22; 95%CI 1.02-1.46) and an interactive effect between weekend operation and teaching status on complications (teaching OR 1.22; 95%CI 1.15-1.29; interaction OR 1.13; 95%CI 1.03-1.25). CONCLUSIONS: There is evidence for a "weekend effect" on mortality, but not complications or FTR, in this cohort.
Authors: Giovanni D Tebala; Marika S Milani; Roberto Cirocchi; Mark Bignell; Giles Bond-Smith; Christopher Lewis; Vanni Agnoletti; Marco Catarci; Salomone Di Saverio; Gianluigi Luridiana; Fausto Catena; Marco Scatizzi; Pierluigi Marini Journal: World J Emerg Surg Date: 2022-04-29 Impact factor: 5.469