In a new study, American doctors have concluded that the danger of performing surgical operations on Friday.
They argue that scheduling surgery on the eve of a weekend is associated with a significantly higher risk of complications and even death compared to other weekdays.
«Among adults who have undergone surgery, the likelihood of adverse postoperative outcomes, including death, readmission, and short- and long-term complications, was increased by 5% for patients who had surgery just before the weekend The effect was observed in many narrow specialties, in particular among patients who underwent elective surgery», — the authors of the study assure.
The conclusions were drawn from a large sample of data in a study involving about 430 thousand patients from the Canadian province of Ontario. The researchers studied the results of surgeries performed on these patients in the period from 2007 to 2019. They analyzed 25 types of the most common surgical interventions performed on Monday and Friday.
«We examined both elective and emergency procedures, analyzed the specific contribution of physician factors (such as age, experience, etc.), and looked at short-term (30 days), medium-term (90 days), and long-term (1 year) outcomes by weekend effect», — explains Vatsala Mundra, a clinical researcher in the Department of Urology at Houston Methodist Hospital and one of the study’s authors.
Results that capture greater risk conducting operations on Friday were also confirmed by other studiesFor example, in the Netherlands, a 2015 study found a 20% increase in 30-day mortality in patients who go under the knife on Friday instead of Monday. A 2018 meta-analysis of more than 8 million patients worldwide found an even greater risk, demonstrating that Friday surgeries were 24% more likely to are more lethal than Monday’s.
The very fact that so many studies have come to the same conclusion is evidence of the effect, the researchers believeThey explain this by saying that the number of medical staff is sharply reduced on the eve of the weekend.
«This may contribute to the weekend effect through the mechanism of failure to rescue — i.e., an understaffed weekend team may be less likely to detect and respond to acute complications early in their development, leading to higher patient complication rates», — the study concludes.
What else is the problem with medical care on weekends?
However, the problem lies not only in the number of medical staff, but also in the type of staff. The authors of the study adjusted their analysis to take into account the characteristics of doctors and found an interesting distorting variable. It is there are often more young surgeons with less experience in the operating room than on Monday.
Weekend medical staff may be less familiar with patients’ problems than the staff who are caring for them on weekdays. In addition, researchers advise taking into account the problem of access to relevant tests, tools, and medical interventions that are usually widely available on weekdays.
«Two days of overworked, less confident staff, with reduced ability to diagnose and treat patients and with less knowledge of the diagnoses and history of the patients they are responsible for? It is a bit surprising that the risk does not increase more than», — the study emphasizes.
However, the researchers have not yet finished figuring out what factors are responsible and what can be done to reduce these negative statistics. Researchers are convinced of the need for a critical analysis current practices of surgical planning and resource allocation.
Surgeons performed endoscopy at a distance of 9300 km using a PlayStation controller
The study was published in the journal JAMA Network Open
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