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Day of week of procedure and 30 day mortality for elective surgery (2013)

bmj.com

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Re: Day of week of procedure and 30 day mortality for elective surgery (2013)

#11

Post by samatman »

mabbo wrote: post #4
glofish wrote: post #2

Almost certainly the selection bias plays a major role - surgeries done early in a week are different than those scheduled later in the week.

Yeah, this reminds me a lot of the "Impossibly Hungry Judges" problem[0]. [0] http://nautil.us/blog/impossibly-hungry-judges

> If hunger had an effect on our mental resources of this magnitude, our society would fall into minor chaos every day at 11:45 a.m.

...this has potential!

Scrape GitHub, find closed issues marked 'bug', do a blame on the offending line or lines, find the timestamp and plot.

Re: Day of week of procedure and 30 day mortality for elective surgery (2013)

#12

Post by L_Rahman »

atlasunshrugged wrote: post #6

Are there any other interesting things like this that people know of? I guess you could consider them advanced life hacks in a way. One things I was thinking of is trying to schedule meetings right after lunch. I'm basing this on the research of judges being more lenient after lunch. https://www.theguardian.com/law/2011/apr/11/judges-lenient-b...

This depends on the kind of meeting you're having. If it's a negotiation with a counterparty, then absolutely schedule for right after lunch. It'd be better if they were a little insulin drowsy after lunch. Ideally you'd be buying them lunch, eating little (or mostly vegetables yourself) while they enjoy an expense account meal.

On the other hand if it's an internal meeting with your team, you want to get them at peak alertness, 10-11 (people settle in for the day, but not hungry for lunch yet), 230-4 (the post lunch blood sugar swing has settled down but people aren't itching to leave just yet)

Re: Day of week of procedure and 30 day mortality for elective surgery (2013)

#13

Post by awinter-py »

uhh guessing it halves the % of failures is what they actually mean

30k deaths / 4 million procedures is 0.75% death rate

going from 99.25% to 99.6% survival isn't doubling anything

also 'success' doesn't appear anywhere in this article, guessing '30 day mortality' is the thing they're measuring

Re: Day of week of procedure and 30 day mortality for elective surgery (2013)

#14

Post by cryptica »

Maybe it's because surgeons on average tend to put off more difficult surgeries to a later day in the week. They don't want to come into the operating theater after a weekend of hard drinking and have to do a complex brain operation on Monday morning.

So they will organize their schedule so that they only do routine low-risk operations on Mondays.

Re: Day of week of procedure and 30 day mortality for elective surgery (2013)

#15

Post by dokein »

jeffdavis wrote: post #8

A mortality rate of 0.7% for elective procedures sounds high. What counts as elective but carries such risk? Is it similar in other countries?

Anything that is scheduled in advance (i.e. not imminently life or limb-threatening) is elective. That includes most transplants, coronary bypasses, removing a tumor from the brain etc.

Re: Day of week of procedure and 30 day mortality for elective surgery (2013)

#16

Post by Fjolsvith »

mabbo wrote: post #4
glofish wrote: post #2

Almost certainly the selection bias plays a major role - surgeries done early in a week are different than those scheduled later in the week.

Yeah, this reminds me a lot of the "Impossibly Hungry Judges" problem[0]. [0] http://nautil.us/blog/impossibly-hungry-judges

Having been through the court system twice, from experience I've seen dockets arranged so that more severe cases are saved for last, and cases with a quick disposition (like probation or fine) are taken care of first.

Edit: This allows the law officials to remove offenders faster from the courtroom.

Re: Day of week of procedure and 30 day mortality for elective surgery (2013)

#17

Post by mgamache »

glofish wrote: post #2

Almost certainly the selection bias plays a major role - surgeries done early in a week are different than those scheduled later in the week.

I am willing to accept bias, but Why would Monday surgeries be statistically different from Wednesday? Clearly weekend surgeries might be different, but the effect is still present Monday-Thursday. I don't work in healthcare so there might be a selection bias that I am blind to, and I am curious if you have a bias in mind. Also they did track specific procedures and for all but one (with a low n) the procedures tracked the results.

Re: Day of week of procedure and 30 day mortality for elective surgery (2013)

#18

Post by bosie »

jeffdavis wrote: post #8

A mortality rate of 0.7% for elective procedures sounds high. What counts as elective but carries such risk? Is it similar in other countries?

They aren't measuring the mortality rate of the procedure. they are measuring this:

"Death in or out of hospital within 30 days of the procedure."

If I am already on my death bed (for lack of better word), the procedure's mortality rate is probably not swaying it much. Also, couldn't find if they would include something like a lethal car accident 28 days after the procedure or not.

> An elective procedure was defined as “elective: from waiting list,” “elective: booked,” or “elective: planned”

High risk procedures seem to be cancer related and specific excisions.

Re: Day of week of procedure and 30 day mortality for elective surgery (2013)

#19

Post by savagedata »

> Choosing Monday for a surgery increases your chance of success 2 times

The title seems poorly worded. The researchers studied mortality rate, not success of procedures. Since these were elective surgeries, I assume the success rate was high. If your surgery has a baseline success rate of 90%, what would it mean to increase that 2 times?

The conclusion of the study was instead that the odds of death were 44% higher on Friday compared to Monday, and 82% higher on the weekend compared to Monday. Basically, there was a gradual increase in the odds of death from Monday to Thursday, but a big jump up on Friday and again on the weekend.

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