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@ARTICLE{Maier:277433,
author = {C. Maier$^*$ and C. Schölch and L. Zhu$^*$ and M. M. Nzomo
and H. L'hoest and U. Marschall and C. Reißfelder and S.
Schölch$^*$},
title = {{W}eekday-dependent long-term outcomes in gastrointestinal
cancer surgery: a german population-based retrospective
cohort study.},
journal = {International journal of surgery},
volume = {109},
number = {10},
issn = {1743-9191},
address = {Amsterdam [u.a.]},
publisher = {Elsevier Science},
reportid = {DKFZ-2023-01370},
pages = {3126-3136},
year = {2023},
note = {#EA:A430#LA:A430# / 2023 Oct 1;109(10):3126-3136},
abstract = {For most solid cancers, surgery represents the mainstay of
curative treatment. Several studies investigating the
effects of the weekday of surgery (WOS) on patient outcomes
have yielded conflicting results. Barmer, the second-largest
health insurance company in Germany, serves roughly $10\%$
of the German population. We have used the Barmer database
to evaluate how the weekday on which the surgery is
performed influences long-term oncologic outcomes.For this
retrospective cohort study, the Barmer database was used to
investigate the effect of the WOS (Monday-Friday) on
outcomes following oncological resections of the colorectum
(n=49,003), liver (n=1,302), stomach (n=5027), esophagus
(n=1126), and pancreas (n=6,097). In total, 62,555 cases
from 2008 to 2018 were included in the analysis. The
endpoints were overall survival (OS), postoperative
complications, and necessity for therapeutic interventions
or re-operations. We furthermore examined whether the annual
caseload or certification as a cancer center influenced the
weekday effect.We observed a significantly impaired OS for
patients receiving gastric or colorectal resections on a
Monday. Colorectal surgery performed on Mondays was
associated with more postoperative complications and higher
probability of re-operations. The annual caseload or a
certification as a colorectal cancer center had no bearing
on the observed weekday effect. There is evidence that
hospitals schedule older patients with more comorbidities
earlier in the week, possibly explaining these findings.This
is the first study investigating the influence of the WOS on
long-term survival in Germany. Our findings indicate that,
in the German healthcare system, patients undergoing
colorectal cancer surgery on Mondays have more postoperative
complications and, therefore, require significantly more
re-operations, ultimately lowering OS. This surprising
finding appears to reflect an attempt to schedule patients
with higher postoperative risk earlier in the week as well
as semi-elective patients admitted on weekends scheduled for
surgery on the next Monday.},
cin = {A430},
ddc = {610},
cid = {I:(DE-He78)A430-20160331},
pnm = {311 - Zellbiologie und Tumorbiologie (POF4-311)},
pid = {G:(DE-HGF)POF4-311},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:37418560},
doi = {10.1097/JS9.0000000000000580},
url = {https://inrepo02.dkfz.de/record/277433},
}