• Luc Dubois, Kelly Vogt, Chris Vinden, Jennifer Winick-Ng, J Andrew McClure, Pavel S Roshanov, Chaim M Bell, Amit X Garg, and Surgical Investigators Group at ICES Western.
• Departments of Surgery (Dubois, Vogt, Vinden) and of Epidemiology and Biostatistics (Dubois, Vogt, Garg), Schulich School of Medicine and Dentistry, Western University, London, Ont.; Institute for Clinical Evaluative Sciences (Vinden, Winick-Ng, McClure, Bell, Garg), Toronto, Ont.; Lilibeth Caberto Kidney Clinical Research Unit (Roshanov), London Health Sciences Centre, London, Ont.; Department of Clinical Epidemiology and Biostatistics (Roshanov), McMaster University, Hamilton, Ont.; Department of Medicine (Bell), Mount Sinai Hospital, University of Toronto, Ont. Luc.Dubois@lhsc.on.ca.
• CMAJ. 2017 Feb 27; 189 (8): E303-E309.

BackgroundIn prior studies, higher mortality was observed among patients who had elective surgery on a Friday rather than earlier in the week. We investigated whether mortality after elective surgery was associated with day of the week of surgery in a Canadian population and whether the association was influenced by surgeon experience and volume.MethodsWe conducted a population-based retrospective cohort study in the province of Ontario, Canada. We included adults who underwent 1 of 12 elective daytime surgical procedures from Apr. 1, 2002, to Dec. 31, 2012. The primary outcome was 30-day mortality. We used generalized estimating equations to compare outcomes for surgeries performed on different days of the week, adjusting for patient and surgeon factors.ResultsA total of 402 899 procedures performed by 1691 surgeons met our inclusion criteria. The median length of hospital stay was 6 (interquartile range 5-8) days. Surgeon experience varied significantly by day of week (p < 0.001), with surgeons operating on Fridays having the least experience. Nearly all of the patients who had their procedure on a Friday had postoperative care on the weekend, as compared with 49.1% of those whose surgery was on a Monday (p < 0.001). We found no difference in the 30-day mortality between procedures performed on Fridays and those performed on Mondays (adjusted odds ratio 1.08, 95% confidence interval 0.97-1.21).InterpretationAlthough surgeon experience differed across days of the week, the risk of 30-day mortality after elective surgery was similar regardless of which day of the week the procedure took place.© 2017 Canadian Medical Association or its licensors.

25 keywords...

hide…