Skip to main content

More deaths from surgery closer to the weekend

Patients undergoing planned surgery appear more likely to die if they have their operation at the end of the week, a study published by Paul Aylin and colleagues in the British Medical Journal has found.

Researchers at Imperial College London looked at over four million elective procedures conducted in NHS hospitals in England between 2008 and 2011. They found that 27,582 patients died within 30 days of surgery. The mortality rate was lowest for patients having operations on Monday, and increased for each subsequent day of the week. The odds of death were 44 per cent higher for operations on a Friday than a Monday.

The risk of dying was higher still for planned procedures carried out at the weekend - 82 per cent greater odds than Monday - but the number of weekend operations was small and may represent a different mix of patients. The authors suggest the findings could reflect differences in the quality of care at the weekend.

"The first 48 hours after an operation are often the most critical period of care for surgery patients," said Dr Paul Aylin, who led the study, from the Department of Primary Care & Public Health at Imperial. "So if the quality of care is lower at the weekend as some previous studies have suggested, we would expect to see higher mortality rates not just for patients operated on at the weekend, but also those who have operations towards the end of the week, whose postoperative care overlaps with the weekend. That is what we found.

"Unlike previous studies, we included both deaths in hospital and deaths after discharge, so this eliminates a potential bias of counting only in-hospital deaths. We tried to account for the possibility that different types of patients might have operations at the end of the week, but our adjustment made little difference. This leaves us with the possibility that the differences in mortality rates are due to poorer quality of care at the weekend, perhaps because of less availability of staff, resources and diagnostic services."

The study was reported widely in the media, including by the BBC.

Comments

Popular posts from this blog

Releasing student potential: Widening access to opportunities in community healthcare

This summer the Department of Primary Care and Public Health kicked off an exciting new programme: Widening Access to Careers in Community Healthcare (WATCCH). We hosted twenty 16-17 year olds who are aspiring to be the first in their families to go to university – at the Charing Cross campus for the inaugural WATCCH project. Our aim was to change perceptions of wider healthcare careers and provide vital work experience for their University applications. Competition was high and the team was very impressed by the number of high calibre students that applied for a place.

Year 12 Pupils from 19 London secondary schools attended an induction day in late July. During the workshop, an experienced multi-professional panel consisting of 5 professionals including an Imperial final year medical student, shared their career journeys with the pupils from their A level to postgraduate degrees. This was followed by pupils creating individual mind maps, which they thoroughly enjoyed, of where they…

Integrated Clinical Apprenticeship - FREQUENTLY ASKED QUESTIONS

WHAT ARE MY MORNING COMMITMENTS? Your Thursday morning and afternoon throughout your year 5 will be dedicated to the Integrated Clinical Apprenticeship. This has been negotiated with the Year 5 course leads and your Specialty supervisors for each firm. Attendance is mandatory for both morning and afternoon sessions.
You will attend your allocated GP surgery on a time negotiated with your GP mentor.
In the morning, you will see patients from your caseload, assessing their clinical needs and bringing yourself up to date with their secondary care contacts. You can then plan with your patient to attend any secondary care appointments in the coming weeks with your patients.
You may also see “ad hoc” patients from the surgery and, if relevant, add them to your caseload. There will be an opportunity to see other health professionals in the primary care team and assist in their daily activities.

WHAT IS MY PATIENT “CASELOAD”?
This is a group of about 12 patients (shared with your pair), recr…

Congratulations to Usama Syed

Usama Syed, a final year medical student in the Faculty of Medicine, was selected for a 2015 Imperial College London Outstanding Student Achievement Award. These awards are to recognize and commend outstanding achievement beyond the academic subject area.  Usama was nominated for his award by the Department of Primary Care and Public Health.

Usama's achievements include:
Founding a new society at the College - MedTech Imperial- designed to bring together students across the medical, engineering, and computing departments, With colleagues coding a brand new mobile phone application designed to streamline the way front-line hospital staff provide feedback and quality improvement ideas to senior medical directors. Researching and writing articles for the official Imperial College website on medical topics for public release.Editing a newsletter for a Health Centre in Clapham, London. In this role, he has written numerous articles for local residents on topics such as travel safety an…