Day of week of procedure and 30 day mortality for elective surgery: Retrospective analysis of hospital episode statistics

Abstract

Objectives: To assess the association between mortality and the day of elective surgical procedure. Design: Retrospective analysis of national hospital administrative data. Setting: All acute and specialist English hospitals carrying out elective surgery over three financial years, from 2008-09 to 2010-11. Participants: Patients undergoing elective surgery in English public hospitals. Main outcome measure: Death in or out of hospital within 30 days of the procedure. Results: There were 27 582 deaths within 30 days after 4 133 346 inpatient admissions for elective operating room procedures (overall crude mortality rate 6.7 per 1000). The number of weekday and weekend procedures decreased over the three years (by 4.5% and 26.8%, respectively). The adjusted odds of death were 44% and 82% higher, respectively, if the procedures were carried out on Friday (odds ratio 1.44, 95% confidence interval 1.39 to 1.50) or a weekend (1.82, 1.71 to 1.94) compared with Monday. Conclusions: The study suggests a higher risk of death for patients who have elective surgical procedures carried out later in the working week and at the weekend.