Surgical Admission at the Weekend and 30-day Mortality in Ontario, Canada: a Matched Cohort Study

NCT03268044 | Unknown

• 1 other identifier: 1000055744
• Study Type: observational
• Target: 340,000
• Locations: 1 country
• Sites: 1

Brief Summary

Surgery is performed at the weekend for risk to life or limb, when mandated by clinical guidelines, or depending on resource availability. Weekend healthcare interventions have been associated with increased mortality and adverse clinical outcomes in the majority of the literature examining the weekend effect, but these findings are not consistent. Results from recent observational studies argue against a true weekend effect. Higher rates of adverse outcomes associated with hospital activity at weekends do not appear to be due to altered medical staffing as commonly hypothesized, but are thought to be in part a result of data artefact and confounding by severity or indication. For this study, we hypothesized that patients who are admitted to hospital at the weekend and require surgery have an increased risk of death compared with patients who are admitted and undergo surgery on weekdays. The primary aim was to examine whether patients who underwent surgery and were admitted at the weekend had an increased risk of 30 day all-cause mortality compared with patients who were admitted and underwent surgery on weekdays; secondary aim was to examine whether the timing of surgery (i.e., surgery on the same weekend or surgery on a subsequent weekday) for patients admitted at the weekend is associated with increased risk of 30 day all-cause mortality.

Conditions

Surgery

Outcome Measures

Primary Outcomes (1)

• 30 day all cause mortality

  death

  30 days from surgery

Study Arms (2)

Weekend admission

Adults admitted to hospital at the weekend (Saturday or Sunday) and who underwent surgery

Other: Hospital admission and surgery

Weekday admission

Adults admitted to hospital on a weekday (Tuesday to Thursday) and who underwent surgery

Other: Hospital admission and surgery

Interventions

Hospital admission and surgery OTHER

Hospital admission and noncardiac surgery

Weekday admission; Weekend admission

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Any hospital admission in Ontario, Canada, between 2005 and 2015 for noncardiac surgery.

You may qualify if:

• any hospital admission associated with an eligible surgical procedure in the Ontario discharge abstract database
• between 2005 and 2015

You may not qualify if:

• cardiothoracic or cardiology therapeutic procedures
• non-surgical therapeutic interventions (e.g. dialysis)
• obstetric procedures.

Sponsors & Collaborators

• The Hospital for Sick Children: lead

Study Sites (1)

The Hospital for Sick Children

Toronto, Ontario, M5G1X8, Canada

RECRUITING

MeSH Terms

Interventions

Surgical Procedures, Operative

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: August 29, 2017
• First Posted: August 31, 2017
• Study Start: October 18, 2016
• Primary Completion: September 15, 2018
• Study Completion: September 15, 2018
• Last Updated: May 9, 2018

Record last verified: 2018-05

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)