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Weekend emergency surgeries deadlier for children
Date:7/2/2014

on to higher risk of dying, weekend procedures carried a higher likelihood of surgical complications, such as inadvertent wound lacerations or punctures, which suggest clinician error or equipment malfunction either during or after surgery. Children undergoing procedures on weekends were 40 percent more likely to develop such complications. In addition, weekend patients were 14 percent more likely to need blood transfusions despite being no more likely than weekday patients to suffer serious blood loss during surgery. Abdullah and colleagues say the reasons for this elevated blood transfusion risk remain unclear but may be due to factors related to post-surgical care. Blood transfusions, although lifesaving, carry their own risks, including a higher rate of wound infection due to temporary suppression of a patient's immune system.

The surgeries examined in the study are considered generally safe and relatively simple and included appendix removal, hernia repairs, draining and cleaning of infected wounds, bone fracture treatment, and surgeries to drain excess fluid in the brain. Overall, cases that showed up at the emergency room on weekends were no more severe than weekday cases, so the conditions themselves did not fuel the higher complication and death risk, the researchers say. The disparity in outcomes persisted even after researchers adjusted their analysis to account for any possible differences in disease severity.

"These are provocative findings and, we hope, a conversation starter," says study lead author Seth Goldstein, M.D., a pediatric surgery resident at Johns Hopkins. "Our next step is to understand the what, how and why behind this alarming disparity."

The Johns Hopkins Children's Center recently launched a program that tracks how children fare in the 30 days following surgery. The data gleaned from the program, the researchers say, should help reveal any glitches or potential vulnerabilities and inform interventions to reduce risk. Such
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Contact: Ekaterina Pesheva
epeshev1@jhmi.edu
410-502-9433
Johns Hopkins Medicine
Source:Eurekalert

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