A ‘weekend effect’ in operative emergency general surgery

Abstract

BackgroundEvidence 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. MethodsNational 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. ResultsOf 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). ConclusionsThere is evidence for a “weekend effect” on mortality, but not complications or FTR, in this cohort.