Try Not To Have Your Child Need An Emergency Appendectomy on a Weekend

You'd probably rather not know this.  But you should.  Children who need even minor emergency surgeries over the weekend are more likely to die.

Children who undergo simple emergency surgeries, such as hernia repairs or appendix removals, on weekends are more likely to suffer complications and even die than children getting the same kind of treatment during the week, according to results of a Johns Hopkins Children’s Center study, as reported by newswise.com.  

"The Johns Hopkins team says that although the number of deaths was small, the marked difference in death and risk of other complications points to a worrisome 'weekend effect' observed across hospitals nationwide that calls for an in-depth examination of possible after-hours safety lapses and clinical glitches," the Web site notes.

Specifically, children who underwent urgent or emergency procedures on weekends were 63 percent more likely to die than those treated during the week, the study showed. The investigators emphasize that an individual patient’s risk of dying was miniscule and the actual deaths attributable to the weekend effect were very few — 30 over the 22 years.

“Numerically speaking, the number of deaths was quite small, but even a single preventable death is one too many. This demands that we examine any factors that may cause or contribute to such occurrences and find ways to prevent them,” says senior investigator Fizan Abdullah, M.D., Ph.D., a pediatric surgeon at the Johns Hopkins Children’s Center.

I wonder if this is similar to the "don't-have-surgery-in-July" theory, which came about because new interns are starting their hospital rotations in that month and many experienced doctors take vacations.

Although the reasons for this weekend effect were not part of the study, the researchers say some possible factors that may fuel the higher risk include decreased weekend staffing, slower response times and decreased availability of certain imaging and lab tests.

Obviously, emergency appendectomies cannot be pre-scheduled, nor can broken bones be properly identified. (On Mother's Day my son broke his wrist, only to be told by an emergency services clinic that he did not.)

“Hospitals must tease out factors such as how many people were there in the OR and ER, how many nurses were on a specific unit, what imaging was done and how soon, and then correlate all these with how well patients do after surgery,” Abdullah says. 

  



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