General SurgeryThe “weekend effect” in urgent general operative procedures
Section snippets
Methods
The Healthcare Cost and Utilization Project (HCUP) State Inpatient Database (SID) from Florida was queried for years 2007–2010. The SID is an administrative, all-payer database aggregated by the Agency for Healthcare Research and Quality. The Institutional Review Board at our institution deemed the study exempt from review because the data is deidentified and publically available.
Each inpatient observation included International Classification of Diseases, 9th Revision, Clinical Modification,
Results
A total of 80,861 admissions met the inclusion criteria, including 61,783 (76.4%) weekday and 19,078 (23.6%) weekend procedures. Exactly 59,963 patients underwent appendectomy, 11,911 underwent cholecystectomy for acute cholecystitis, and 9,515 underwent hernia repair for obstructed/gangrenous hernia.
Patients undergoing urgent surgery on the weekend were slightly younger (39.3 years ± 21.5 vs 40.2 years ± 21.5; P < .001), more likely to have insurance status uninsured/other (15.9% vs 13.9%; P
Discussion
This study investigated differences in outcomes between patients undergoing common urgent surgeries on weekends versus weekdays. Using the HCUP-SID, we demonstrated that urgent weekend inpatient stays were associated with greater charges and greater rates of wound complications and UTIs. We found weekend cholecystectomies were associated with greater DOS and charges, whereas appendectomies resulted in more transfusions, sepsis, wound complications, and UTIs. Importantly, these differences
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