Scheduling surgery can be a stressful experience, and a new study suggests the day of the week might play a role in patient outcomes. Research published in JAMA Network Open indicates that surgeries performed right before the weekend, primarily on Fridays, carry a slightly elevated risk compared to those scheduled earlier in the week. This “weekend effect” raises questions about how hospitals can optimize patient care and safety throughout the week.
This research, conducted by scientists in the U.S. and Canada, analyzed data from nearly half a million patients. The study found a small but statistically significant increase in the risk of death, complications, and readmissions following pre-weekend surgeries compared to post-weekend procedures. These findings highlight potential areas for improvement in hospital practices, particularly regarding weekend staffing levels.
Interestingly, this isn’t the first time these researchers have explored the calendar’s impact on surgery. A previous study investigated whether surgeries performed on Friday the 13th had worse outcomes. Fortunately, the results showed no difference, debunking that particular superstition.
However, previous research has hinted at a potential weekend effect on surgical outcomes. Anecdotally, some of the researchers themselves have noticed variations in weekend patient care. To investigate this further, they analyzed medical records of over 400,000 residents in Ontario, Canada, who underwent common surgical procedures.
“Our study is unique because we analyzed both elective and emergent procedures, considered physician factors like age and experience, and examined short-term (30-day), intermediate-term (90-day), and long-term (1-year) outcomes related to the weekend effect,” explained study researcher Vatsala Mundra, a clinical research fellow at Houston Methodist Urology.
The study revealed a slight but significant association between pre-weekend surgeries and negative outcomes. Pre-weekend surgeries had a 5% higher combined risk of death, complications, and readmissions in both the short and long term compared to post-weekend procedures. This increased risk was observed across various specialties and procedures, although it was more pronounced for elective surgeries and specific fields like orthopedics and urology.
Because the study analyzed data from multiple hospitals and similar findings have emerged from research in other countries, the researchers believe this weekend effect is likely a widespread phenomenon in healthcare systems globally. The primary contributing factor, according to Mundra, appears to be reduced staffing levels.
“Pre-weekend surgeries may be riskier because patients often require weekend post-operative care, and studies have shown a significant decrease in physician, nurse, and clinical staff presence over the weekend,” she noted. This suggests that hospitals could potentially mitigate this risk by increasing weekend staffing and improving communication between weekend staff and senior or primary care physicians.
The research team plans to continue investigating how less obvious factors can impact hospital stays. “We aim to further explore the effects of various social and cultural phenomena on surgical outcomes to highlight disparities and inefficiencies,” Mundra stated.
The findings of this study underscore the importance of considering scheduling factors when planning surgery. While the increased risk is relatively small, it highlights the need for hospitals to prioritize consistent staffing levels and resource availability throughout the week to ensure optimal patient care and safety. Further research is needed to identify specific interventions that can effectively address this weekend effect and improve surgical outcomes for all patients.
