Huijts DD, et al. - Researchers investigated if there exists an association between the emergency weekend colon and rectal cancer surgery and worse outcomes (ie, weekend effect) since previous studies mostly used administrative data, which may insufficiently adjust for case-mix. They reported higher mortality and severe complication rates related to weekend emergency colon cancer surgery.

Methods

• Researchers used prospectively collected data from the 2012–2015 Dutch ColoRectal Audit (n=5224).
• They studied the differences in 30-day mortality and severe complication and failure-to-rescue rates for emergency weekend (Saturday and Sunday) vs Monday surgery, stratified for colon and rectal cancer, using analyses adjusted for age, sex, body mass index, Charlson comorbidity index, American Society of Anesthesiologists classification score, tumor stage, presence of metastasis, preoperative complication, additional resection for metastasis or locally advanced tumor, location primary colon tumor, type of rectal surgery (lower anterior resection or abdominal perineal resection), and type of neoadjuvant therapy (short-course radiotherapy or chemoradiotherapy). 

Results

•  This study included a total of 5052 patients undergoing colon cancer surgery and 172 undergoing rectal cancer surgery.
• They found that patients undergoing colon or rectal cancer surgery during weekends vs those undergoing surgery on a weekday had significantly more preoperative tumor complications.
• For colon cancer surgery, they found differences in year of surgery and location of primary tumor.  
• Findings demonstrated that emergency colon cancer surgery during the weekend vs surgery on Monday was related to increased 30-day mortality (odds ratio [OR], 1.66; 95% CI, 1.10–2.50) and severe complications (OR, 1.29; 95% CI, 1.03–1.63).
• Similar estimates were reported for emergency weekend rectal cancer surgery, but were not statistically significant, likely explained by small numbers.