Weekend effect on operative mortality following coronary artery bypass grafting.

Abstract

Background

Whether patients undergoing coronary artery bypass grafting (CABG) late in the workweek or on weekends experience excess mortality remains controversial.Methods

Medicare beneficiaries undergoing isolated CABG from 2008 to 2019 were stratified by day of surgery (DOS; Monday-Sunday). A flexible parametric model adjusting for demographics, comorbidities, surgeon/hospital volume, and procedural details was used to evaluate whether CABG-DOS was associated with 30-day mortality. Regression standardization was applied to estimate standardized survival probabilities (SSPs). SSPs for CABG performed on Friday, Saturday, and Sunday were compared to those for CABG performed on Monday to Thursday in the overall cohort and within cohorts defined by admission urgency (proxy for surgical urgency).Results

Among 735,603 beneficiaries undergoing CABG, surgery was performed on Friday in 144,220 (19.6%), Saturday in 18,568 (2.5%), and Sunday in 11,502 (1.6%). From Monday to Friday, approximately 50% of CABGs were elective; elective CABG composed 30% of Saturday cases and 22% of Sunday cases. Risk-adjusted 30-day SSPs were similar for CABGs performed on Monday to Thursday (97.0%; 95% confidence interval [CI], 96.9%-97.1%) and Friday (97.1%; 95% CI, 97.0%-97.2%) but were lower for CABGs performed on Saturday (96.2%; 95% CI, 95.9%-96.4%) and Sunday (95.4%; 95% CI, 95.0%-95.7%). A weekend effect on mortality was persistent across all admission urgency levels.Conclusions

Compared with weekday operations, weekend CABG was associated with 1 to 2 excess mortalities per 100 procedures. These findings suggest that environmental factors specific to DOS, unique to weekends, and present regardless of case urgency may adversely impact early post-CABG survival.

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Cite

BibTeX RIS

BibTeX

@article{squiers2026weekend,
  title = {{Weekend effect on operative mortality following coronary artery bypass grafting.}},
  author = {John J Squiers and Cody Dorton and Taylor Pickering and Jasjit K Banwait and Sarah Hale and J Michael DiMaio and Justin M Schaffer},
  journal = {JTCVS open},
  year = {2026},
  month = jul,
  doi = {10.1016/j.xjon.2026.101984},
  url = {https://europepmc.org/article/MED/42948420},
  note = {CC BY-NC-ND},
}

RIS

TY  - JOUR
TI  - Weekend effect on operative mortality following coronary artery bypass grafting.
AU  - John J Squiers
AU  - Cody Dorton
AU  - Taylor Pickering
AU  - Jasjit K Banwait
AU  - Sarah Hale
AU  - J Michael DiMaio
AU  - Justin M Schaffer
PY  - 2026
DA  - 2026/07/31
JO  - JTCVS open
DO  - 10.1016/j.xjon.2026.101984
UR  - https://europepmc.org/article/MED/42948420
AB  - Background  Whether patients undergoing coronary artery bypass grafting (CABG) late in the workweek or on weekends experience excess mortality remains controversial.Methods  Medicare beneficiaries undergoing isolated CABG from 2008 to 2019 were stratified by day of surgery (DOS; Monday-Sunday). A flexible parametric model adjusting for demographics, comorbidities, surgeon/hospital volume, and procedural details was used to evaluate whether CABG-DOS was associated with 30-day mortality. Regression standardization was applied to estimate standardized survival probabilities (SSPs). SSPs for CABG performed on Friday, Saturday, and Sunday were compared to those for CABG performed on Monday to Thursday in the overall cohort and within cohorts defined by admission urgency (proxy for surgical urgency).Results  Among 735,603 beneficiaries undergoing CABG, surgery was performed on Friday in 144,220 (19.6%), Saturday in 18,568 (2.5%), and Sunday in 11,502 (1.6%). From Monday to Friday, approximately 50% of CABGs were elective; elective CABG composed 30% of Saturday cases and 22% of Sunday cases. Risk-adjusted 30-day SSPs were similar for CABGs performed on Monday to Thursday (97.0%; 95% confidence interval [CI], 96.9%-97.1%) and Friday (97.1%; 95% CI, 97.0%-97.2%) but were lower for CABGs performed on Saturday (96.2%; 95% CI, 95.9%-96.4%) and Sunday (95.4%; 95% CI, 95.0%-95.7%). A weekend effect on mortality was persistent across all admission urgency levels.Conclusions  Compared with weekday operations, weekend CABG was associated with 1 to 2 excess mortalities per 100 procedures. These findings suggest that environmental factors specific to DOS, unique to weekends, and present regardless of case urgency may adversely impact early post-CABG survival.
SN  - 2666-2736
ER  -

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