Mortality for emergency laparotomy is not affected by the weekend effect: a multicentre study

作者：Haritharan Nageswaran, Vijayendran Rajalingam, Anil Kumar Sharma, AO Joseph, M. Davies, Huw Geraint Jones, Martyn D. Evans · 发表于：Annals of The Royal College of Surgeons of England · 年份：2019 · DOI：10.1308/rcsann.2019.0037 · 被引用次数：12 · 研究领域：Hospital Admissions and Outcomes、Enhanced Recovery After Surgery、Sleep and Work-Related Fatigue

Introduction The ‘weekend effect’ describes variation in outcomes of patients treated over the weekend compared with those treated during weekdays. This study examines whether a weekend effect exists for patients who undergo emergency laparotomy. Materials and methods Data entered into the National Emergency Laparotomy Audit between 2014 and 2017 at four NHS trusts in England and Wales were analysed. Patients were grouped into those admitted on weekdays and those on weekends (Friday 5pm to Monday 8am). Patient factors, markers of quality of care and patient outcomes were compared. Secondary analysis was performed according to the day of surgery. Results After exclusion of patients who underwent laparotomy more than one week after admission to hospital, a total of 1717 patients (1138 patients admitted on weekdays and 579 admitted on weekends) were analysed. Age, preoperative lactate and P-POSSUM scores were not significantly different between the two groups. Time from admission to consultant review, decision to operate, commencement of antibiotics and theatre were not significantly different. Grades of operating surgeon were also similar in both groups. Inpatient 60-day mortality was 12.5% on weekdays and 12.8% on weekends (P = 0.878). Median length of postoperative stay was 12 days in both groups. When analysed according to day of surgery, only number of hours from admission to antibiotics (12.8 weekday vs 9.4 weekend, P = 0.046) and number of hours to theatre (26.5 weekday v...