Day of surgery: the impact on patient length of stay in a tertiary vascular unit.

Abstract

BACKGROUND\nOur hypothesis was that patients undergoing surgery earlier in the week would have better access to physiotherapy and other discharge services after surgery and, as a result, would have a shorter length of hospital stay compared with patients undergoing surgery later in the week. This study aimed to assess whether there is a significant difference in postoperative length of hospital stay between the groups with secondary assessment by operation subtype.\n\n\nMETHODS\nWe identified all patients admitted for vascular surgery in 2015 from a prospectively collected database and divided the week into Monday to Wednesday and Thursday to Friday. Endovascular cases were included but day cases were excluded. Further analysis was performed with a breakdown in both groups by operation type. Statistical analysis was performed using SPSS version 16.0.\n\n\nRESULTS\nWe identified 652 patients who met our criteria. Within the elective patient group, there was a significantly longer length of stay of three days for the late-week group compared with two days for the early-week group (P = 0.016). Femoral artery procedures had a median length of stay of two days for those operated on early in the week compared with four days later in the week (P < 0.005). Open abdominal aortic aneurysm repair showed a trend to longer length of stay in the late-week group (P = 0.06).\n\n\nCONCLUSION\nDay of surgery appears to impact on patients length of stay following vascular procedures, with the greatest impact on medium-sized procedures. This difference could be explained by the difference in weekend support services, but further evaluation is required following introduction of weekend support services to assess this.