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

Mathias Worni, Truls Østbye, Mihir Gandhi, Dimple Rajgor, Jatin Shah, Anand Shah, Ricardo Pietrobon, Danny O. Jacobs, Ulrich Guller

Research output: Contribution to journalArticle

25 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1527-1533
Number of pages7
JournalWorld Journal of Surgery
Volume36
Issue number7
DOIs
StatePublished - Jul 1 2012

ASJC Scopus subject areas

  • Surgery

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    Worni, M., Østbye, T., Gandhi, M., Rajgor, D., Shah, J., Shah, A., Pietrobon, R., Jacobs, D. O., & Guller, U. (2012). Laparoscopic appendectomy outcomes on the weekend and during the week are no different: A national study of 151,774 patients. World Journal of Surgery, 36(7), 1527-1533. https://doi.org/10.1007/s00268-012-1550-z