Meta-analysis supports ‘weekend effect’ for surgical patients

Editor's Note

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, this meta-analysis from the University of Calgary finds.

The analysis included 10 studies that involved about 6.7 million patients having elective procedures and 19 studies that involved more than 1.4 million patients having urgent/emergent procedures.

For elective surgery, postoperative mortality increased as the day of surgery approached the weekend. The difference became significant for surgery performed on Thursday or Friday. The odds of death were 12% higher for Thursday procedures and 24% higher for Friday procedures, compared to those performed on Monday.

For urgent/emergent procedures, the odds of postoperative mortality were 27% higher for patients admitted to the hospital on Saturday or Sunday, compared to those admitted on a weekday.

Future research should focus on clarifying underlying causes of this association and developing strategies to improve safety and mitigate adverse events associated with weekend surgical care, the researchers say.

are 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.

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