‘Weekend effect’ is real: You’re less likely to die from surgery early in week

CALGARY, Alberta — What do you do when the weekend finally rolls around? Go root for your favorite team? Maybe catch the latest flick? Run errands? Whatever you do, there is one thing you should avoid if at all possible: having surgery. A new study finds that patients’ survival rates drop when they opt for surgical procedures on a weekend.

Researchers say that when it comes to elective surgeries, do not plan to use your weekend to recover, either. Having a procedure at the beginning of the week is safest. Simply put, the “weekend effect” is not something you want to put to the test.

Doctors performing surgery
Whatever your weekend plans are, there is one thing you should avoid: having surgery. A new study finds that patients’ survival rates drop when they opt for surgical procedures on a weekend.

What is the weekend effect? Past studies have linked weekend healthcare to poorer outcomes. Researchers at the University of Calgary carried out the most thorough study yet on the weekend effect as it impacts surgical outcomes, whether for elective (scheduled) or emergency surgeries.

“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 compared to weekdays,” the authors write in their findings. “This phenomenon has become known as the ‘weekend effect’ and has been speculated to result from decreased staffing and resource availability, leading to shortfalls in care and poor outcomes.”

Study co-author Dr. Stephen Smith and his colleagues at the school studied data for both weekend emergency surgeries as well as outcomes for weekday surgeries scheduled on Thursdays and Fridays. The postoperative time period right after surgery is the highest-risk time for post-surgical complications. Either one of these situations places patients in the most vulnerable recovery period on weekend days.

Researchers pored over data that had been collected in 10 previous studies on the surgical outcomes of about 6.7 million patients who had scheduled surgeries. Elective surgeries are rarely scheduled on weekend days, but researchers wanted to find out what happens when patients schedule surgeries on Thursdays or Fridays versus on the earlier days of the workweek.

They found a gradual increase in postoperative mortality for elective surgeries as the days advanced toward the weekend. By the end of the week, a marked rise became evident. When compared to surgeries performed on a Monday, the odds of death were 12% higher for surgeries done on a Thursday and 24% higher for surgeries performed on a Friday.

For emergency surgeries, researchers combed over data from 19 studies of more than 1.4 million patients. They found that when patients were admitted on either a Saturday or a Sunday for emergency surgeries, the odds of dying postoperatively were 27% higher than for patients admitted on a weekday.

Researchers caution that even though their study is quite comprehensive, it does have its limitations. Although statistically patients are at a higher risk for postoperative mortality on certain days, the study does not tell us why this increase occurs in relation to weekend recovery periods.

“Future studies should focus on clarifying the contributing factors to poor outcomes and developing strategies to potentially improve safety and mitigate adverse events associated with weekend surgical care,” the authors conclude.

The full study was published in the February 2018 issue of the journal Medical Care.