Appendix Removal Complications Worse on Weekend?

Weekend appendectomies have similar complication rates as weekday procedures

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

Some surgeries on the abdomen are prone to the "weekend effect," where complications and illnesses occur more often when procedures are done on Saturday and Sunday compared to the rest of the week. Appendix removal, however, may not be a part of that effect.

New research presented at a conference found that patients who had their appendix removed over the weekend did not have more complications post-surgery than patients who underwent the procedure during the week. 

Though the findings have not yet been peer reviewed, the findings suggest that patients "...should not wait for the weekend to pass to go to the hospital."

"Talk to your doctor if you are having appendicitis symptoms."

John N. Afthinos, MD, a surgeon at Staten Island University Hospital, led a study that investigated whether removing the appendix, called an appendectomy, over the weekend versus during the week led to higher rates of illnesses and mortality among patients.

The researchers tracked almost 826,000 patients who underwent an appendectomy and were listed in the National Inpatient Sample Database between 2006 and 2009.

Appendectomies were both laparoscopic and open, with the former involving smaller incisions into the gut.

All patients had appendicitis, which is when the appendix swells, becomes inflamed and is at risk of bursting. The patients were assigned to have their appendix removed during the week or over the weekend.

Mortalities, complications and hospital charges were noted, as well as the length of time patients stayed in the hospital.

In total, 790,940 of all the appendectomies, or almost 96 percent, occurred during the week. 

About 68 percent of the patients had laparoscopic appendectomies, and the rest had open procedures.

The number of patients who had laparoscopic versus open procedures did not differ significantly from the week to the weekend, and both groups stayed in the hospital about two days on average.

The number of complications that occurred among weekend appendectomy patients was not significantly different than the number that occurred weekday appendectomy patients, the researchers found.

Complications occurred in about 1.4 percent of each group. For every 10,000 patients, two deaths occurred.

The researchers also found that weekend appendectomies cost an extra $400 on average compared to weekday appendectomies.

Procedures during the weekend cost $22,028 on average compared to $21,609 during the week.

The researchers said that based on previous studies, weekend appendectomy patients who had other gastrointestinal operations had a higher risk of complications after their procedures.

But the researchers said this could be from reduced staffing in hospitals on the weekend.

“From what we can see, there’s no difference in the quality of patient care between weekend and weekday admissions of patients who have an appendectomy,” said Dr. Afthinos said in a press release. “Patients with symptoms of acute appendicitis should not wait for the weekend to pass to go to the hospital.”

The study was presented October 7 at the 2013 Clinical Congress of the American College of Surgeons.

Review Date: 
October 8, 2013
Last Updated:
October 9, 2013