Getting surgery before the weekend? Bad idea, study claims

According to a new study, people who have surgery on a Friday are better off rescheduling it if possible.

People who go in for surgery just before the weekend have a significantly higher risk of death and complications, researchers reported in the March issue of JAMA Network Open.

This “weekend effect” was observed for 25 common surgeries representing several surgical specialties, the researchers said.

“Patients who underwent surgery just before the weekend had a significantly increased risk of complications, re-hospitalizations, and mortality compared to those treated after the weekend,” concluded the team led by senior investigator Dr. Raj Satkunasivam of Houston Methodist Hospital in Texas.

“It is important for health systems to evaluate how this phenomenon may impact their practices to ensure patients receive excellent care regardless of the day of the week,” the researchers added.

Hospitals and other health care facilities typically operate on weekends with limited teams, setting the stage for poorer patient care on Saturday and Sunday, the researchers noted in the background information. This phenomenon is commonly referred to as the “weekend effect.”

The weekend effect may also apply to people who have surgery just before the weekend and will be in the hospital recovering from the procedure, the researchers explain.

To find out, researchers analyzed data on nearly 430,000 patients who underwent surgery in Ontario, Canada, between 2007 and 2019.

The results showed that people who had surgery the day before the weekend had a higher risk of dying within 30 days (9% increase), 90 days (10%) and one year (12%) compared to patients who had surgery after the weekend.

Surgical patients operated on the day before the weekend also had worse performance on a composite measure including death, complications, and need for re-hospitalization, with a 5% increased risk at 30 days and one year after surgery.

In addition to staff reductions, there are other reasons why hospitals may provide worse care closer to the weekend, the researchers said.

More young surgeons with less years of experience operate on Friday than on Monday, say the researchers, and doctors working on weekends have less access to more experienced colleagues and specialists.

In addition, weekend teams may not be as familiar with patients as weekday teams who have previously treated them.

Physicians may also have less access to investigations and tests that could better help treat patients, the researchers added.

“Further study is needed to understand the differences in care that may underlie these observations and to ensure that patients receive high-quality care regardless of the day of the week,” the researchers concluded.