A paper just published by the JAMA Online (it can be downloaded below) shows a small but “significant increase in risk of complications, readmissions, and mortality compared with those treated after the weekend. Further study is needed to understand differences in care that may underpin these observations and ensure that patients receive high-quality care regardless of the day of the week.”
The belief that surgery performed late in the week is riskier than that performed at its start of the week has been thought true since I entered the profession. Hospitals operate with greatly reduced medical staff on weekends allowing for surgical complications to take longer to be observed than would happen with a full staff.
You have to dig deep into this study to find the supportive evidence for the statement made above about adverse events, but it’s there. Look at the figure and you will see which types of surgeries do worse when performed at the end of the week. Cardiovascular surgery has the worst end of the week outcomes of all the classes of surgery examined.
I always advised my patients to schedule their operations for Monday or Tuesday. The week-end effect is not a new concept, but it has not been as thoroughly studied as in the paper.
