Surgery on Friday? No, thanks!

If you have a choice of dates to have elective surgery, go for Monday if possible. And definitely, don’t have surgery on Friday or on a Thursday before a long holiday weekend. What’s the difference?

 

Researchers studied over 450,000 common surgeries performed in Toronto between 2007-2019. They looked at 30-day, 90-day, and one-year outcomes for patients. They checked for complications during the hospital stay, readmission to the hospital, and death within those time periods.

 

People whose surgery was on a pre-weekend day were 5% more likely to have a negative outcome up to a year later than were people whose surgery was on a post-weekend day (Monday, or Tuesday after a long weekend). The surgeries in which this effect was most noticeable were for heart and vascular problems. Plastic surgery and obstetrics showed very little calendar-related effects.

 

This is not just a Canadian phenomenon. Similar research has been done in the UK, in the US, and in the Netherlands. It has been labeled the “Friday effect.”

 

Several theories exist to explain this effect. It is possible that hospital staff on duty over weekends are less experienced or more overworked, which might lead to delayed or less efficient care. Specialist care may be less available on weekends. Some researchers concluded that “disparities in resources, expertise, and healthcare providers working during weekends may explain the observed differences in weekend mortality.”

 

However, sometimes there does not seem to be a Friday effect. A study of elective anterior cervical discectomy and fusion (ACDF) surgery found that “the day of elective ACDF surgery does not affect mortality, readmissions, or reoperation rates.” The authors note that it is likely that there may be more negative outcomes for patients with early-week surgeries because surgeons prefer to schedule “more complex cases or higher risk patients” earlier rather than later in the week.

 

Conclusion: It’s always wise to ask lots of questions before elective surgery. Be your own best advocate. And remember that even if there are risks, they seem to be small.