Impact of Weekend Effect on Short- and Long-Term Survival of Patients Undergoing Esophagectomy for Cancer: A Population-Based, Inverse Probability of Treatment-Weighted Analysis
Background We examined the impact of the weekend effect on the survival outcomes of patients undergoing elective esophagectomy for cancer. Methods This was a retrospective analysis of a nationwide, health administrative dataset that included all patients ( n = 3235) who had undergone elective esopha...
Saved in:
Published in | Annals of surgical oncology Vol. 30; no. 6; pp. 3790 - 3798 |
---|---|
Main Authors | , , |
Format | Journal Article |
Language | English |
Published |
Cham
Springer International Publishing
01.06.2023
Springer Nature B.V |
Subjects | |
Online Access | Get full text |
Cover
Loading…
Summary: | Background
We examined the impact of the weekend effect on the survival outcomes of patients undergoing elective esophagectomy for cancer.
Methods
This was a retrospective analysis of a nationwide, health administrative dataset that included all patients (
n
= 3235) who had undergone elective esophagectomy for cancer in Taiwanese hospitals between 2008 and 2015. Patients were categorized according to the day of surgery (weekday group: surgical procedures starting Monday through Friday,
n
= 3148; weekend group: surgical procedures starting on Saturday or Sunday,
n
= 87). Inverse probability of treatment weighting (IPTW) using the propensity score was used to account for selection bias due to baseline differences.
Results
After IPTW, patients undergoing esophagectomy on weekends had a higher 90-days mortality rate compared with those undergoing surgery on a weekday (10.5% vs. 5.5%, respectively,
P
< 0.001). After controlling for potential confounders, weekend surgery was identified as an independent adverse predictor of 2-years, overall survival [hazard ratio (HR) = 1.38,
P
< 0.001]. Importantly, inferior weekend outcomes were especially evident in certain subgroups, including patients aged > 60 years (HR = 1.61,
P
< 0.001), as well as those with a high burden of comorbidities (HR = 1.32,
P
< 0.001), advanced tumor stage (HR = 1.50,
P
< 0.001), histological diagnosis of squamous cell carcinoma (HR = 1.20,
P
< 0.001), and treated with minimally invasive esophagectomy (HR = 1.26,
P
< 0.001).
Conclusions
Elective esophagectomy for cancer during weekends has an adverse impact on short- and long-term survival. |
---|---|
Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 1068-9265 1534-4681 |
DOI: | 10.1245/s10434-023-13280-2 |