A new study suggests that emergency surgery done on children during the weekend results in more complications and deaths than similar surgery done during the week.
The study, published in the July issue of The Journal of Pediatric Surgery, used a large national database to match 112,064 weekend operations on children younger than 18 with 327,393 operations performed on weekdays. The selected operations were performed on the day of admission and the procedures performed — appendectomies, brain shunts, hernias, bone fractures and abscess drainage procedures — were coded as emergencies in the database.
Only about 1 percent of cases had complications, and less than one-tenth of 1 percent of the children died. But even after controlling for sex, age, race, the type of surgery and other factors, patients having a procedure on the weekend were 40 percent more likely to sustain an accidental puncture or cut, 14 percent more likely to receive a transfusion, and 63 percent more likely to die.
The lead author, Dr. Seth D. Goldstein, a surgical resident at Johns Hopkins, said that even though mortality was quite low, if weekend treatment had matched weekday treatment over the 20-year period of the study, about 50 deaths would have been prevented.
“Parents should know that as providers of surgical care, we are not satisfied with excellence,” he added. “We want these things to be never events.”