Access the full text.
Sign up today, get DeepDyve free for 14 days.
M. Jamal, S. Doi, M. Rousseau, M. Edwards, C. Rao, J. Barendregt, L. Snell, S. Meterissian (2012)
Systematic review and meta‐analysis of the effect of North American working hours restrictions on mortality and morbidity in surgical patientsBritish Journal of Surgery, 99
M. Worni, Inge Schudel, Truls Østbye, Anand Shah, Aarti Khare, R. Pietrobon, J. Thacker, U. Guller (2012)
Worse outcomes in patients undergoing urgent surgery for left-sided diverticulitis admitted on weekends vs weekdays: a population-based study of 31 832 patients.Archives of surgery, 147 7
Emergency operations performed on weekends are associated with more complications than those performed on weekdays. The article by Worni et al1 highlights the problem of the influence of available surgical expertise on the postoperative outcomes of a very common disease. They analyzed data on more than 31 000 patients with left-sided diverticulitis, categorized into 2 groups admitted on weekends vs weekdays. The authors showed that admission during the weekend significantly increased the risk of postoperative complications and the frequency of performance of a Hartmann procedure. The key question remains why surgery for such a common disease as left-sided diverticulitis is significantly more dangerous during a weekend admission. Work hour restrictions do not seem to have a negative influence on mortality and morbidity in surgical patients.2 However, reduced experience owing to restricted working hours may negatively influence the practical skills of younger surgeons, resulting in more limited surgery (eg, a Hartmann procedure being performed instead of a primary anastomosis) and an increase in complications related to that surgery. Do we need more specialized surgeons to overcome this problem, or is it necessary to change our education system? In the end, quality is expensive, and our society has to decide if it is desirable and necessary to have the best surgical quality available all the time, especially when considering that health care costs will dramatically increase. It would be relevant to analyze additional large databases, asking similar questions about the outcomes of other common diseases (eg, appendicitis, cholecystitis, and strangulated hernias) and studying the effect of weekend admission on these illnesses. Back to top Article Information Correspondence: Dr Metzger, Department of Surgery, Cantonal Hospital Lucerne, Spitalstrasse, CH-6000 Lucerne 16, Switzerland (juerg.metzger@luks.ch). Financial Disclosure: None reported. References 1. Worni M, Schudel IM, Østbye T, et al. Worse outcomes in patients undergoing urgent surgery for left-sided diverticulitis admitted on weekends vs weekdays: a population-based study of 31 832 patients. Arch Surg. 2012;147(7):soa120020649-655Google Scholar 2. Jamal MH, Doi SA, Rousseau M, et al. Systematic review and meta-analysis of the effect of North American working hours restrictions on mortality and morbidity in surgical patients. Br J Surg. 2012;99(3):336-34422241280PubMedGoogle ScholarCrossref
Archives of Surgery – American Medical Association
Published: Jul 1, 2012
Keywords: diverticulitis,surgical procedures, operative,surgery specialty,surgeons,weekend
Read and print from thousands of top scholarly journals.
Already have an account? Log in
Bookmark this article. You can see your Bookmarks on your DeepDyve Library.
To save an article, log in first, or sign up for a DeepDyve account if you don’t already have one.
Copy and paste the desired citation format or use the link below to download a file formatted for EndNote
Access the full text.
Sign up today, get DeepDyve free for 14 days.
All DeepDyve websites use cookies to improve your online experience. They were placed on your computer when you launched this website. You can change your cookie settings through your browser.