Weekend effect on operative mortality following coronary artery bypass grafting

IF 2.2

JTCVS open Pub Date : 2026-10-01 Epub Date: 2026-07-31 DOI:10.1016/j.xjon.2026.101984

John J. Squiers MD, Cody Dorton DO, Taylor Pickering DO, Jasjit K. Banwait PhD, Sarah Hale MS, J. Michael DiMaio MD, Justin M. Schaffer MD

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引用次数: 0

Abstract

Background

Whether patients undergoing coronary artery bypass grafting (CABG) late in the workweek or on weekends experience excess mortality remains controversial.

Methods

Medicare beneficiaries undergoing isolated CABG from 2008 to 2019 were stratified by day of surgery (DOS; Monday-Sunday). A flexible parametric model adjusting for demographics, comorbidities, surgeon/hospital volume, and procedural details was used to evaluate whether CABG-DOS was associated with 30-day mortality. Regression standardization was applied to estimate standardized survival probabilities (SSPs). SSPs for CABG performed on Friday, Saturday, and Sunday were compared to those for CABG performed on Monday to Thursday in the overall cohort and within cohorts defined by admission urgency (proxy for surgical urgency).

Results

Among 735,603 beneficiaries undergoing CABG, surgery was performed on Friday in 144,220 (19.6%), Saturday in 18,568 (2.5%), and Sunday in 11,502 (1.6%). From Monday to Friday, approximately 50% of CABGs were elective; elective CABG composed 30% of Saturday cases and 22% of Sunday cases. Risk-adjusted 30-day SSPs were similar for CABGs performed on Monday to Thursday (97.0%; 95% confidence interval [CI], 96.9%-97.1%) and Friday (97.1%; 95% CI, 97.0%-97.2%) but were lower for CABGs performed on Saturday (96.2%; 95% CI, 95.9%-96.4%) and Sunday (95.4%; 95% CI, 95.0%-95.7%). A weekend effect on mortality was persistent across all admission urgency levels.

Conclusions

Compared with weekday operations, weekend CABG was associated with 1 to 2 excess mortalities per 100 procedures. These findings suggest that environmental factors specific to DOS, unique to weekends, and present regardless of case urgency may adversely impact early post-CABG survival.

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冠状动脉旁路移植术术后死亡率的周末效应

背景：在工作日晚些时候或周末接受冠状动脉旁路移植术（CABG）的患者是否会有更高的死亡率仍然存在争议。方法对2008年至2019年接受孤立性冠脉搭桥的医疗保险受益人按手术日期（DOS；周一至周日）进行分层。采用灵活的参数模型调整人口统计学、合并症、外科医生/医院数量和手术细节，以评估CABG-DOS是否与30天死亡率相关。采用回归标准化方法估计标准化生存概率（ssp）。将周五、周六和周日进行CABG的ssp与周一至周四进行CABG的ssp在整个队列中进行比较，并根据入院紧急程度（代替手术紧急程度）定义队列。结果735,603例冠脉搭桥受益人中，周五手术144,220例（19.6%），周六18,568例（2.5%），周日11,502例（1.6%）。从周一到周五，大约50%的cabg是选修的；选择性冠脉搭桥占周六病例的30%，周日病例的22%。周一至周四（97.0%；95%可信区间[CI]， 96.9%-97.1%）和周五（97.1%;95% CI, 97.0%-97.2%）行cabg的风险调整30天ssp相似，但周六（96.2%;95% CI, 95.9%-96.4%）和周日（95.4%;95% CI, 95.0%-95.7%）行cabg的风险调整30天ssp较低。周末对死亡率的影响持续存在于所有急诊级别。结论与工作日手术相比，周末冠脉搭桥每100例手术死亡率高出1 ~ 2例。这些研究结果表明，DOS特有的环境因素，周末特有的环境因素，无论病例是否紧急，都可能对cabg后早期生存产生不利影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JTCVS open

CiteScore

1.70

自引率

0.00%

发文量