Abstract
BACKGROUND: Hospitals usually reduce staffing levels and services over weekends. This raises the question of whether patients discharged over a weekend may be inadequately prepared and possibly at higher risk of adverse events post-discharge.
OBJECTIVES: To assess the outcomes of common general surgery procedures for patients discharged over weekends, and to identify the key predictors of early readmission.
DESIGN: Retrospective cohort study.
SETTING: A tertiary care center.
PATIENTS AND METHODS: Patients discharged from general surgery services during the one-year period between January and December 2016 after cholecystectomy, appendectomy, or hernia repairs were included. Patient demographic information, comorbidities, and complications as well as admission and follow-up details were collected from electronic medical records.
MAIN OUTCOME MEASURES: Outcomes following weekend discharge, and the predictors of early readmission.
SAMPLE SIZE: 743 patients.
RESULTS: The operations performed: 361 patients (48.6%) underwent a cholecystectomy, 288 (38.8%) an appendectomy, and 94 (12.6%) hernia repairs. A significantly lower number of patients were discharged over the weekend (n=125) compared to those discharged on weekdays (n=618). Patients discharged during the weekend were younger, less likely to have chronic diseases, and had a significantly shorter average length of stay (LOS) (median 2 days, IQR: 1, 4 vs. median 3 days, IQR: 1, 5, P=.002). Overall, the 30-day readmission rate was 3.2% (n=24), and weekend discharge (OR=2.25, 95% CI 0.52-9.70) or any other variable did not predict readmission in 30 days. However, 14-day postdischarge follow-up visits were significantly lower in the weekend discharge subgroup (83.1% vs. 91.2%, P=.006).
CONCLUSION: Weekend discharge was not associated with higher readmission rates. Physicians may consider discharging post-operative patients over a weekend without an increased risk to the patient. Day of discharge, length of stay and increased patient age are not predictors of early readmission.