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Weekend Surgical Care and Postoperative Mortality
- Source :
- Medical Care
- Publication Year :
- 2018
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2018.
-
Abstract
- Supplemental Digital Content is available in the text.<br />Background: An association between weekend health care delivery and poor outcomes has become known as the “weekend effect.” Evidence for such an association among surgery patients has not previously been synthesized. Objective: To systematically review associations between weekend surgical care and postoperative mortality. Methods: We searched PubMed, EMBASE, and references of relevant articles for studies that compared postoperative mortality either; (1) according to the day of the week of surgery for elective operations, or (2) according to weekend versus weekday admission for urgent/emergent operations. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for postoperative mortality (≤90 d or inpatient mortality) were pooled using random-effects models. Results: Among 4027 citations identified, 10 elective surgery studies and 19 urgent/emergent surgery studies with a total of >6,685,970 and >1,424,316 patients, respectively, met the inclusion criteria. Pooled odds of mortality following elective surgery rose in a graded manner as the day of the week of surgery approached the weekend [Monday OR=1 (reference); Tuesday OR=1.04 (95% CI=0.97–1.11); Wednesday OR=1.08 (95% CI=0.98–1.19); Thursday OR=1.12 (95% CI=1.03–1.22); Friday OR=1.24 (95% CI=1.10–1.38)]. Mortality was also higher among patients who underwent urgent/emergent surgery after admission on the weekend relative to admission on weekdays (OR=1.27; 95% CI=1.08–1.49). Conclusions: Postoperative mortality rises as the day of the week of elective surgery approaches the weekend, and is higher after admission for urgent/emergent surgery on the weekend compared with weekdays. Future research should focus on clarifying underlying causes of this association and potentially mitigating its impact.
- Subjects :
- Male
medicine.medical_specialty
Time Factors
Databases, Factual
Weekend effect
Names of the days of the week
education
MEDLINE
030204 cardiovascular system & hematology
Cohort Studies
surgery
03 medical and health sciences
0302 clinical medicine
After-Hours Care
Humans
Medicine
Hospital Mortality
Postoperative Period
030212 general & internal medicine
Elective surgery
business.industry
Public Health, Environmental and Occupational Health
Original Articles
Odds ratio
Length of Stay
mortality
Confidence interval
3. Good health
Hospitalization
Elective Surgical Procedures
Surgical Procedures, Operative
Meta-analysis
Emergency medicine
ComputingMethodologies_DOCUMENTANDTEXTPROCESSING
Female
weekend care
business
weekend effect
human activities
Cohort study
Subjects
Details
- ISSN :
- 00257079
- Volume :
- 56
- Database :
- OpenAIRE
- Journal :
- Medical Care
- Accession number :
- edsair.doi.dedup.....bf5f4c36f0eb324167057f34f395b309