Laparoscopic appendectomy outcomes on the weekend and during the week are no different: a national study of 151,774 patients.

Published

Journal Article

BACKGROUND: The "weekend effect" is defined as increased morbidity and mortality for patients admitted on weekends compared with weekdays. It has been observed for several diseases, including myocardial infarction and renal insufficiency; however, it has not yet been investigated for laparoscopic appendectomy in acute appendicitis-one of the most prevalent surgical diagnoses. METHODS: The present study is based on the Nationwide Inpatient Sample (NIS) from 1999 to 2008. The following outcomes were compared between patients undergoing laparoscopic appendectomy for acute appendicitis admitted on weekdays versus weekends: severity of appendicitis, intraoperative and postoperative complications, conversion rate, in-hospital mortality, and length of hospital stay. Unadjusted and risk-adjusted generalized linear regression analyses were performed. RESULTS: Overall, 151,774 patients were included, mean age was 39.6 years, 52.6% (n = 79,801) were male, and 25.3% (n = 38,317) were admitted on weekends. After risk adjustment, the conversion rate was lower [odds ratio (OR): 0.94, p = 0.004, number needed to harm (NNH): 244], whereas pulmonary complications (OR: 1.12, p = 0.028, NNH: 649) and reoperations (OR: 1.21, p = 0.013, NNH: 1,028) were slightly higher on weekends than on weekdays. Overall postoperative complications (OR: 1.03, p = 0.24), mortality (OR: 1.37, p = 0.075) and length of hospital stay (mean on weekday: 2.00 days, weekends: 2.01 days, p = 0.29) were not statistically different. CONCLUSIONS: The present investigation provides evidence that no clinically significant "weekend effect" for patients undergoing laparoscopic appendectomy exists. Therefore, hospital or staffing policy changes are not justified based on the findings from this large national study.

Full Text

Duke Authors

Cited Authors

  • Worni, M; Østbye, T; Gandhi, M; Rajgor, D; Shah, J; Shah, A; Pietrobon, R; Jacobs, DO; Guller, U

Published Date

  • July 2012

Published In

Volume / Issue

  • 36 / 7

Start / End Page

  • 1527 - 1533

PubMed ID

  • 22411091

Pubmed Central ID

  • 22411091

Electronic International Standard Serial Number (EISSN)

  • 1432-2323

Digital Object Identifier (DOI)

  • 10.1007/s00268-012-1550-z

Language

  • eng

Conference Location

  • United States