Weekend Surgery is More Risky than Weekday Surgery
June 16, 2013
by Robert Wascher
Filed under A Cancer Prevention Guide for the Human Race, death, health, Hospital Staffing, ICU, Intensive Care Unit, medical errors, Medication Errors, mortality, risk, Risk of Death, surgery, Weekday Surgery, Weekend Surgery, Weekly Health Update
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A new study notes a much higher risk of death associated with surgery performed at the end of the week, compared with Monday surgeries.
WEEKEND SURGERY IS MORE RISKY THAN WEEKDAY SURGERY Previous studies have suggested that surgeries performed after hours and on the weekends are associated with a greater risk of death when compared to surgeries performed earlier in the week. This finding is not particularly surprising, as patients who undergo surgery after hours and on weekends are more likely to be undergoing surgery for emergency conditions, and are likely to be more severely ill, compared with patients who are undergoing elective scheduled surgery on weekdays. However, a newly published research study shows that elective non-emergency surgeries are also associated with a much greater risk of death when performed at the end of the week or on weekends, when compared with elective surgeries performed early in the week. This clinical research study appears in the current issue of the British Medical Journal. A retrospective study reviewed hospital data between 2008 and 2010 for all public hospitals in England. In particular, the outcomes of patients undergoing elective surgery were analyzed. Altogether, 4,133,346 inpatient admissions for elective surgery were evaluated. These more than 4 million surgical cases were associated with 27,582 deaths within 30 days of surgery. When compared to elective surgeries performed on Mondays, elective non-emergency surgeries performed on Fridays were associated with a 44 percent increase in the risk of death. The news for elective surgeries conducted over the weekend was even worse. Compared to Monday surgeries, elective surgeries conducted over the weekend were associated with an 82 percent increase in the risk of death! English public hospitals, like most hospitals in the United States, sharply reduce their staffing levels on weekends. Given that life-threatening complications associated with major operations are most likely to occur during the first 72 hours following surgery, it is not surprising that major operations performed on Fridays or weekends, even elective non-emergency operations, are associated with a higher risk of complications and death, as the patient safety benefit associated with full weekday staffing in the hospital is lost on weekends (and holidays) in the vast majority of hospitals. In my own Surgical Oncology practice, I routinely schedule major elective surgeries at the beginning of the week, in recognition of what has been called the “weekend effect.” I and my Surgical Oncology colleague also personally see all of our surgical patients seven days a week, including weekends and holidays, in an effort to ensure that their ongoing care meets the highest standards, and to closely follow their postoperative recoveries. Unfortunately, not all complications, and not all deaths, can be prevented following surgery. However, data from clinical research studies such as this study provide important opportunities to reduce postoperative complications, including the “ultimate complication,” to the lowest achievable levels.
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Additional Links for Robert A. Wascher, MD, FACS CNN Story on CTCA’s Organic Farm in the Phoenix Area Dr. Wascher Discusses Signs & Symptoms of Skin Cancer Profile of Dr. Wascher by Oncology Times Bio of Dr. Wascher at Cancer Treatment Centers of America Dr. Wascher Discusses Predictions of Decreased Cancer Risk on azfamily.com Dr. Wascher Discusses Environmental Risk Factors for Breast Cancer on Sharecare Dr. Wascher Answers Questions About Cancer on talkabouthealth.com Dr. Wascher Discusses Cancer Prevention Strategies on LIVESTRONG Dr. Wascher Discusses Cancer Prevention on Newsmax Dr. Wascher Answers Questions About Cancer Risk & Cancer Prevention on The Doctors Radio Show Dr. Wascher Discusses Lymphedema After Breast Surgery on cancerlynx.com Dr. Wascher Discusses Hormone Replacement Therapy & Breast Cancer Risk on cancerlynx.com Dr. Wascher Discusses Chronic Pain After Mastectomy for Breast Cancer on cancerlynx.com Dr. Wascher Discusses Sentinel Lymph Node Biopsy for Cancer on cancersupportivecare.com Dr. Wascher Discusses the Role of Exercise in Cancer Prevention on Open Salon Dr. Wascher Discusses Aspirin as a Potential Preventive Agent for Pancreatic Cancer on eHealth Forum Dr. Wascher Discusses Obesity & Cancer Risk on eHealth Forum Dr. Wascher Discusses the Role of Radiation Therapy in the Treatment of Breast Cancer on Sharecare Dr. Wascher Discusses the Treatment of Stomach Cancer on Sharecare Dr. Wascher Discusses the Management of Metastatic Cancer of the Liver on Sharecare Dr. Wascher Discusses Obesity & Cancer Risk on hopenavigators.com Dr. Wascher Discusses Hormone Replacement Therapy & Breast Cancer Risk on interactmd.com Dr. Wascher Discusses Thyroid Cancer on health2fit.com
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According to recent Bureau of Labor Statistics, the unemployment rate for veterans who served on active duty between September 2001 and December 2011 is more than 12 percent. A new website, Veterans in Healthcare, seeks to connect veterans with potential employers. If you are a veteran who works in the healthcare field, or if you are an employer who is looking for physicians, advanced practice professionals, nurses, corpsmen/medics, or other healthcare professionals, then please take a look at Veterans in Healthcare. As a retired veteran of the U.S. Army, I would also like to personally urge you to hire a veteran whenever possible. Disclaimer: As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author
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