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'Weekday effect' on mortality

A recent publication co-authored by member of the department Dr Roxana Alexandrescu has received extensive coverage in the national press, and on radio and television.

Previous research suggested a significantly higher risk of death if admitted as an emergency at the weekend compared with the weekday (‘weekend effect’); however, little had been done on planned procedures and the influence of the weekday on these procedures. In this retrospective analysis of Hospital Episodes Statistics database, including in-hospital and post-discharge deaths, we found that the adjusted odds of death in the 30 days after elective surgical procedures were 44% and 82% higher if the procedures were carried out on Friday or at the weekend, respectively, compared with Monday.

This is the first study to report a ‘weekday effect’, in addition to the well known ‘weekend effect’ on hospital mortality, in a large national representative database. The results show higher risk of death for patients who have elective surgical procedures carried out closer to the weekend, in particular on Friday. Although the reasons behind this remain unknown, taking into account that serious complications are more likely to occur within the first 48 hours post-operatively, the study suggests the weekend management of postoperative patients needs to be improved.

P Aylin, R Alexandrescu, MH Jen, EK Mayer, A Bottle. Day of week of procedure and 30 day mortality for elective surgery: A retrospective analysis of hospital episode statistics. BMJ 2013;346:f2424