T. Chambers2, F. Velez-Cubian2, C. Moodie1, J. Garrett1, J. Fontaine1,2, E. Toloza1,2 1Moffitt Cancer Center And Research Institute,Tampa, FL, USA 2University Of South Florida College Of Medicine,Tampa, FL, USA
Introduction: The purpose of this study was to assess if patients who underwent surgery received immediate postoperative care at the beginning of the week (Monday through Wednesday [M-W]) had different outcomes than patients who had surgery and immediate postoperative care at the end of the week (Thursday and Friday [Th-F]). In theory, surgical patients at the end of the week would receive different care due to their postoperative care being given by a partial weekend staff as compared to the full staff during the work week. This is important to this practice because if there is a difference in outcomes, hospital staffing for weekend care should be adjusted accordingly.
Methods: Patients, who underwent robotic-assisted pulmonary lobectomy from 2010 to 2016, were divided into the M-W group or the Th-F group according to their surgical day of the week. Patient demographics, tumor histopathology, intraoperative and postoperative complications, and perioperative outcomes were assessed and compared between groups using independent samples t-test, Pearson Chi-square analysis, Levene’s test, Mann-Whitney U test, and Fisher’s exact test, with significance at p≤0.05.
Results: There were 344 patients in the study cohort. After analysis of each of these variables, the Th-F groups had a median skin-to-skin operative time that was 23 minutes longer than that for the M-W group and a median total operative time that was 27 minutes longer than that for the M-W group. There were significantly more non-small cell lung cancer (NSCLC) and larger tumors resected in the M-W than in the Th-F group. There were no significant differences between the two groups in the other variables assessed.
Conclusions: NSCLC tumors were more common in the M-W group and tended to be larger tumors; however, these tumors took less time to resect. These differences in outcomes based on surgical day of the week could be due to differences in surgeon and/or surgical team performance during different days of the week. Surgical team schedules should be varied to allow more veteran surgical members to be distributed evenly among the week, which can help lower median surgical times and the amount of anesthesia exposure needed for each case. Future studies can look to see if this finding continues across other procedures.