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WEEKDAY OR WEEKEND HOSPITAL ADMISSION: DOES IT MATTER FOR ACUTE CARE SURGERY?

Ibrahim Albabtain1, Roaa Alsuhaibani1, Sami Almalki1, Nada Alhassan2, Hassan Arishi1, Hatim Alsulaim1. 1King Abdulaziz Medical City, 2King Saud bin Abdulaziz University for Health Scinces

Introduction: During weekends, hospitals usually reduce their staffing levels and services. This might result in decreased quality of healthcare or so-called the weekend effect. In this study, we aimed to determine the impact weekends on two common emergency general surgeries and their outcomes, in terms of day of operation and admission.

Methods and Procedures: This retrospective cohort study was conducted at a tertiary care hospital between January and December 2016. Surgical procedures included were cholecystectomy and appendectomy. Patients’ demographic, co-morbidities, admission date, surgery date, complications, readmission and follow-up details were collected from the electronic medical records. Post-operative outcomes associated with weekend admission were identified by multivariable analysis using univariable and multivariable logistic regression models controlling for potential confounders.

Results: A total of 539 patients were included. Median age for weekday admissions was 31 years (IQR: 22, 45), and 32 years (IQR: 23, 49.75) for weekend admissions. The majority of patients were admitted during weekdays (n= 391). No significant difference was found in the type of surgery performed between weekday and weekend admissions (p-value 0.384). Surgeries tend to be delayed by a median of one day for weekend admissions compared to weekdays with similar overall length of stay for both groups. Weekend admissions were associated with higher complication rates compared with weekday admissions (12.2% vs. 6.1%). Regarding the day of surgery, 444 surgeries were performed during weekdays while 86 surgeries were performed during weekends. Patients who were operated on weekends were younger in age compared with weekdays (32 vs. 30 years old, p-value 0.019). The percentage of female patients undergoing surgery during weekends was lower compared with weekdays (40.7% vs. 53.8%). Both groups had similar complication rates (7.7 in weekdays vs. 9.3% in weekends, p-value .605). During weekends, appendectomies were performed more (77.9% vs. 45.9%), and less cholecystectomies were performed (22.1% vs. 54.1%, p-value 0.000).

Conclusions: Patients admitted on weekends tended to have their surgeries delayed by one day, with more complication rates. Patient operated on over weekends were younger and less likely to be females. Appendectomy was the most common performed surgery over the weekend.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 93664

Program Number: P010

Presentation Session: Poster Session (Non CME)

Presentation Type: Poster

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