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Chirurgia 2020 October;33(5):244-8

DOI: 10.23736/S0394-9508.19.05084-8


language: English

Weekend admission does not affect outcomes on acute cholecystitis

Fawaz ABDUL RAHEEM 1 , Saba AL-SADDAH 1, Sarah AL BEN ALI 1, Zakariya HASSAN 1, Jasim ALABBAD 1, 2

1 Department of Surgery, Mubarak Al-Kabeer Hospital, Jabriya, Kuwait; 2 Department of Surgery, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait

BACKGROUND: The quality of care delivered to patients may vary on the weekend compared to the weekdays, affecting a multitude of clinical conditions. There is conflicting evidence regarding the presence of the weekend effect in the delivery of care to patient’s acute cholecystitis. To compare the management between patients with acute cholecystitis admitted on the weekend and those admitted on the weekday, and to elucidate whether the weekend effect is present in this patient population.
METHODS: A total of 223 adult patients with acute cholecystitis who were admitted from January 2017 to October 2018 were analyzed retrospectively. Data were collected using patient medical records.
RESULTS: There were 125 and 98 patients admitted during the weekday and weekend, respectively. There was no difference in the management between patients presenting on the weekend and those presenting on the weekday who underwent operative management during the initial admission (63.3% vs. 60.8%, P value=0.71). There were no differences in morbidity (15.5 vs. 17.6%, P value= 0.67) or mortality (3% vs. 0.8%, P value= 0.21) between those admitted on the weekend and those admitted on the weekday.
CONCLUSIONS: Our study shows that there is no weekend effect in the management of acute cholecystitis. Patients with acute cholecystitis who were admitted over the weekend had no measurable differences in common health quality metrics when compared to those admitted on the weekday. Acute Care Surgery follows a system-based approach and reconfiguration of delivery of care independent of day of week that mitigates the consequences of the weekend effect. Patients presenting with acute cholecystitis on the weekend were no more likely to receive NOM, did not have longer duration to surgery date and length of stay, or did not have higher complication rates than those admitted on the weekday.

KEY WORDS: General surgery; Cholecystitis, acute; Patient safety

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