MedPath

Surgical Admission at the Weekend and 30-day Mortality in Ontario, Canada: a Matched Cohort Study

Conditions
Surgery
Interventions
Other: Hospital admission and surgery
Registration Number
NCT03268044
Lead Sponsor
The Hospital for Sick Children
Brief Summary

Surgery is performed at the weekend for risk to life or limb, when mandated by clinical guidelines, or depending on resource availability. Weekend healthcare interventions have been associated with increased mortality and adverse clinical outcomes in the majority of the literature examining the weekend effect, but these findings are not consistent. Results from recent observational studies argue against a true weekend effect. Higher rates of adverse outcomes associated with hospital activity at weekends do not appear to be due to altered medical staffing as commonly hypothesized, but are thought to be in part a result of data artefact and confounding by severity or indication. For this study, we hypothesized that patients who are admitted to hospital at the weekend and require surgery have an increased risk of death compared with patients who are admitted and undergo surgery on weekdays. The primary aim was to examine whether patients who underwent surgery and were admitted at the weekend had an increased risk of 30 day all-cause mortality compared with patients who were admitted and underwent surgery on weekdays; secondary aim was to examine whether the timing of surgery (i.e., surgery on the same weekend or surgery on a subsequent weekday) for patients admitted at the weekend is associated with increased risk of 30 day all-cause mortality.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
340000
Inclusion Criteria
  • any hospital admission associated with an eligible surgical procedure in the Ontario discharge abstract database
  • between 2005 and 2015
Exclusion Criteria
  • cardiothoracic or cardiology therapeutic procedures
  • non-surgical therapeutic interventions (e.g. dialysis)
  • obstetric procedures.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Weekend admissionHospital admission and surgeryAdults admitted to hospital at the weekend (Saturday or Sunday) and who underwent surgery
Weekday admissionHospital admission and surgeryAdults admitted to hospital on a weekday (Tuesday to Thursday) and who underwent surgery
Primary Outcome Measures
NameTimeMethod
30 day all cause mortality30 days from surgery

death

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

The Hospital for Sick Children

🇨🇦

Toronto, Ontario, Canada

© Copyright 2025. All Rights Reserved by MedPath