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Surgeries on Friday Are More Frequently Fatal

You're better off being a case on a Monday.
An X-Ray slide via the Public Domain Review

Friday is great for all sorts of thing—high school football, a block of family-oriented ABC shows and binge drinking come readily to mind—but it’s a pretty lousy day to have surgery.

Not just because you’ll miss out on the above rituals but because, according to a report in the British Medical Journal, compared to those who opt for really bad Mondays, Britons who have a planned surgery on a Friday are 44 percent more likely to die. And the few patients who had a leisurely weekend surgery saw that number jump to 82 percent. The skeleton staff working on weekends might be to blame.

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Researchers stressed, however, that not only is the weekend surgery sample size small, it is also likely biased in some way—perhaps only the already-most desperate of patients would have an operation on the weekend. Operations scheduled for Friday, though, are more comfortably compared to Monday, and the jump in mortality rates is striking.

The report states “the reasons behind this remain unknown, but we know that serious complications are more likely to occur within the first 48 hours after an operation.” Hospitals running with a reduced, weekend staff during these crucial, first few days after surgery might be at the root of the problem. The report didn't make a big deal out of it, but mortality rates steadily rose throughout the week, but they jumped dramatically on Friday and over the weekend.

They looked at mortality rates for the 30 days following one of five “higher risk major surgical procedure groups” particularly ones that would likely warrant a stay in the intensive care unit.

This phenomenon is hardly unique to England, even if it is dramatically pronounced. A similar study conducted in American Veterans Affairs hospitals found that the odds of a patient dying in the 30 days following surgery jumped when the surgery happened on Friday.

You’d like to think of medicine as applied uniformly and fairly but small, seemingly capricious things like the day of the week when the surgery happens, as it turns out, may have life and death implications. Just like judges who are more likely to convict when they're hungry, hospitals are all too fallibly human.