VOLUME 38 | ISSUE 2 | MARCH-APRIL 2018

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Outcomes of common general surgery procedures for patients discharged over weekends at a tertiary care hospital in Saudi Arabia

Ibrahim T. Albabtain,a Roaa S. Alsuhaibani,b Sami A. Almalki,b Hassan A. Arishi,a Hatim A. Alsulaima

From the aDepartment of Surgery, King Abdulaziz Medical City, Riyadh, Saudi Arabia; bCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia 

How to cite this article:

Albabtain IT, Alsuhaibani RS, Almalki SA, Arishi HA, Alsulaim HA. Outcomes of common general surgery procedures for patients discharged over weekends at a tertiary care hospital in Saudi Arabia. Ann Saudi Med 2018; 38(2): 105-110.

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 post-discharge 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.

 

LIMITATIONS: Single-center study and retrospective.

 

CONFLICT OF INTEREST: None. 

 

 

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