The “Weekday Effect”—Does It Impact Esophageal Cancer Surgery Outcomes?

Abstract

Background: Increased 30-day mortality rates have been reported in patients undergoing elective surgery later compared with earlier in the week. However, these reports have been con icting for esophageal surgery. We conducted a study to assess the differences in outcomes of patients undergoing surgery for esophageal cancer earlier in the week (Tuesday) versus later (Friday).Methods: This retrospective analysis of a prospectively maintained database included patients with esophageal cancer who underwent esophageal resection in a tertiary cancer centre between 1 st January 2005 and 31 st December 2017. We compared patients operated on Tuesdays versus Fridays. The primary outcome was a composite of major morbidity (de ned as Clavien-Dindo grade 3 or more) and/or mortality. Secondary outcomes included duration of post-operative ventilation, and length of ICU and hospital stay.Results: Among 1300 patients included, 733 were operated on Tuesday and 567 on Friday. Patient and surgery characteristics were similar in the two groups. The primary outcome (composite of major morbidity and mortality) was 23.6% in the Tuesday group versus 26.3% in the Friday group. Mortality was similar in the two groups (6.0%). Multivariable logistic regression analysis showed that the day of surgery was not a predictor of major morbidity or mortality.Conclusions: In patients undergoing esophagectomy at tertiary care high volume cancer centre, there was no difference in major morbidity and mortality whether the surgery was performed early in the week(Tuesday) or closer to the weekend(Friday).

Weekday-dependent long-term outcomes in gastrointestinal cancer surgery: a german population-based retrospective cohort study

“…This observation hints at a potential systematic phenomenon tied to operational practices within healthcare settings. However, this ‘weekday effect’ hypothesis is not unanimously supported as other studies found no significant impact of the day of the week on the outcomes of elective oncological resections 6 – 8 . This discrepancy in findings could be attributed to variations in healthcare systems between countries, differences in study design, or disparities in the clinical conditions being studied.…”