Al-Ashqar Mohammad, Aqil Adeel, Phillips Hannah, Sheikh Hassaan, Harrison Simon, Sidhom Sameh, Chakrabarty Gautam, Dimri Ravinder
Calderdale and Huddersfield NHS Foundation Trust , Huddersfield , UK.
Ann R Coll Surg Engl. 2018 Sep;100(7):551-555. doi: 10.1308/rcsann.2018.0084. Epub 2018 Jun 18.
Introduction The 'weekend effect' is said to occur when patient outcomes are adversely affected by the day of the week on which they present to hospital or have surgery. However, it is uncertain whether such a phenomenon exists for elective orthopaedic surgery. We investigated whether there is a 'weekend effect' in elective orthopaedic patients. Methods Retrospectively collected data were obtained from our institution's electronic patient records. We collected demographic and International Statistical Classification of Diseases and Related Health Problems tenth revision coding data for all included patients. Multivariate analyses identified covariate-adjusted risk factors, associated with prolonged stays. Thirty-day mortality data were assessed according to the day on which surgery occurred. Results We analysed data for 892 patients over a one-year period. During the year, 457 patients had a total hip and 435 had a total knee replacement; 814 patients (91.3%) underwent surgery during the week, while 78 (8.7%) had surgery on a Saturday. There was no difference in average length of stay between the groups (5.0, 2.6 vs 5.0, 3.4, P = 0.95). Variables associated with prolonged hospitalisation included increasing age (covariate adjusted relative risk 1.02, 95% confidence interval 1.01-1.03, P < 0.001) and an American Society of Anesthesiologists score of 2, (relative risk 1.6, 95% confidence interval 1.15-2.20, P = 0.005). There was one death in a patient who underwent surgery on a Monday. Conclusions There is no 'weekend effect' for elective orthopaedic surgery.
引言 当患者的治疗结果受到其前往医院就诊或接受手术的日期影响时,就被认为存在“周末效应”。然而,对于择期骨科手术是否存在这样的现象尚不确定。我们调查了择期骨科患者中是否存在“周末效应”。
方法 从我们机构的电子病历中回顾性收集数据。我们收集了所有纳入患者的人口统计学数据以及国际疾病分类第十次修订本编码数据。多变量分析确定了与住院时间延长相关的协变量调整风险因素。根据手术发生的日期评估30天死亡率数据。
结果 我们分析了一年期间892例患者的数据。在这一年中,457例患者进行了全髋关节置换术,435例患者进行了全膝关节置换术;814例患者(91.3%)在工作日接受手术,而78例患者(8.7%)在周六接受手术。两组之间的平均住院时间没有差异(5.0、2.6对5.0、3.4,P = 0.95)。与住院时间延长相关的变量包括年龄增加(协变量调整相对风险1.02,95%置信区间1.01 - 1.03,P < 0.001)以及美国麻醉医师协会评分为2(相对风险1.6,95%置信区间1.15 - 2.20,P = 0.005)。有1例在周一接受手术的患者死亡。
结论 择期骨科手术不存在“周末效应”。