Death risk from surgery higher at end of week


Patients who have elective surgery at the end of the week or at the weekend have a greater risk of death, according to a study published in the BMJ.

The research by Imperial College London found that death rates for planned surgery are lowest on Mondays and increase for each subsequent day of the week. Odds of death were 44 per cent higher for patients who had planned operations on a Friday than on a Monday.

The study looked at 27,582 deaths out of 4.1m elective surgeries carried out in England between 2008 and 2011. It found that 5.5 per 1,000 hospital procedures on Monday died within 30 days rising to 8.2 on Fridays.

The researchers from Imperial questionned whether the findings may be due to lower staff ratios and poorer care at the weekend:

“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,” said Dr Paul Aylin, who led the study, from the School of Public Health at Imperial.

“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.”

Previous research had found worse outcomes for patients admitted to hospital as an emergency at weekends, but the new study finds a much stronger weekday effect for elective procedures.

As well as looking at the data as a whole, the researchers studied death rates for several specific high risk procedures, and found the same trend for higher mortality close to the weekend.