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Inicio Cirugía Española (English Edition) The «weekday effect» does not have an impact on the development of complicatio...
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Vol. 99. Issue 4.
Pages 296-301 (April 2021)
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Vol. 99. Issue 4.
Pages 296-301 (April 2021)
Original article
The «weekday effect» does not have an impact on the development of complications or mortality after pulmonary resection: Retrospective cohort study
El «efecto día de la semana» no tiene impacto en la aparición de complicaciones o mortalidad tras la resección pulmonar: estudio de cohortes histórico
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María Teresa Gómez Hernández
Corresponding author
, Nuria Novoa Valentín, Israel Rodríguez Alvarado, Marta Fuentes Gago, José Luis Aranda, Marcelo F. Jiménez López
Departamento de Cirugía Torácica, Hospital Universitario de Salamanca, Salamanca, Spain
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Tables (3)
Table 1. Patient characteristics.
Table 2. Probabilities of cardiorespiratory complications and operative death (30 days) in the 2 cohorts, calculated Eurolung 1 and 2 risk models, respectively.
Table 3. Incidence of cardiorespiratory complications, technical complications and 30-day mortality among exposed and unexposed patients.
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Abstract
Objective

To determine whether elective anatomic pulmonary resection surgery carried out at the end of the week is associated with a higher mortality and postoperative morbidity than surgery performed at the beginning of the week.

Method

Historical cohort study. All patients undergoing anatomical pulmonary resection between January 2013 and November 2018 in our center were included. Patients operated at the end of the week (Thursday or Friday) were considered «not exposed» and patients operated at the beginning of the week (Monday, Tuesday or Wednesday) were considered «exposed». The likelihood of cardiorespiratory complications and operative death (30 days) was compared in the two cohorts calculated using the Eurolung 1 and 2 risk models. 30-day mortality and the occurrence of cardiorespiratory and technical complications were studied as outcome variables. The incidence of these adverse effects was calculated for the overall series and for both cohorts, and the relative risk (RR) and its 95% confidence interval (95% CI) were determined.

Results

The overall mortality of the series was 0.9% (10/1172), the incidence of cardiorespiratory complications was 10.2% (120/1172) and that of technical complications was 20.6% (242/1172). The RR calculated for cardiorespiratory, technical complications and mortality in exposed and unexposed subjects was: 0.914 (95% CI: 0.804–1.039), 0.996 (95% CI: 0.895–1.107) and 0.911 (95% CI: 0.606–1.37), respectively.

Conclusions

Patients operated at the end of the week do not present a higher risk of postoperative adverse effects.

Keywords:
Pulmonary resection
Weekday
Postoperative complications
Resumen
Objetivo

Determinar si la cirugía de resección pulmonar anatómica electiva llevada a cabo al final de la semana se asocia con una mayor morbimortalidad postoperatoria que la cirugía realizada al inicio de la semana.

Método

Estudio de cohortes histórico en el que se incluyeron todos los pacientes sometidos a resección pulmonar anatómica entre el 1 de enero de 2013 y 1 de noviembre de 2018 en nuestro centro. Se consideraron «expuestos» los pacientes intervenidos al final de la semana (jueves o viernes) y «no expuestos» los intervenidos al inicio de la semana (lunes, martes o miércoles). Se comparó la probabilidad de complicaciones cardiorrespiratorias y muerte operatoria (30 días) en las dos cohortes calculada mediante los modelos de riesgo Eurolung 1 y 2. Como variables de resultado se estudiaron la mortalidad a 30 días y la ocurrencia de complicaciones cardiorrespiratorias relacionadas con la técnica postoperatoria. Se calculó la incidencia de estos efectos adversos para la serie global y para ambas cohortes y se determinó el riesgo relativo (RR) y su intervalo de confianza al 95% (IC 95%).

Resultados

La mortalidad global de la serie fue del 0,9% (10/1.172), la incidencia de complicaciones cardiorrespiratorias fue del 10,2% (120/1.172) y la de complicaciones técnicas, del 20,6% (242/1.172). El RR calculado para las complicaciones cardiorrespiratorias, técnicas y mortalidad en expuestos y no expuestos fue: 0,914 (IC 95%: 0,804–1,039), 0,996 (IC 95%: 0,895–1,107) y 0,911 (IC 95%: 0,606–1,37), respectivamente.

Conclusiones

Los pacientes intervenidos al final de la semana no presentan un mayor riesgo de efectos adversos postoperatorios.

Palabras clave:
Resección pulmonar
Día de la semana
Complicaciones postoperatorias

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