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

bmj.com

31–40 of 88 posts

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

#31

Pro tip: if getting a colonoscopy, always always get the first appointment of the day. I work in med devices and ummm those scopes still have poop left over between procedures. Its not harmful, but still...

I'm no expert but aren't you exposing one patient to the previous patient's poop? There could be anything from a lovely c-diff payload to something the next guy is allegeric to like nuts. As a layperson it hardly seems harmless.

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

#32

Pro tip: if getting a colonoscopy, always always get the first appointment of the day. I work in med devices and ummm those scopes still have poop left over between procedures. Its not harmful, but still...

Wait for real? How would that not be insanely dangerous and risky in terms of fecal cross contamination and disease transfer? Do you have a source for standard treatment procedure to not include using a sterilized scope?

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

#34

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

Yeah that's the main reason i had to read it. Even if you got to 100 percent on Monday that would imply only 50 percent success on other days. Nobody would have an elective procedure with that low success rate.

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

#35

Pro tip: if getting a colonoscopy, always always get the first appointment of the day. I work in med devices and ummm those scopes still have poop left over between procedures. Its not harmful, but still...

Huh. I asked my retired endo nurse mom about that, and she said (at least at her hospital), that’s not possible.

So, I’d recommend not going to the hospitals this dude services.

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

#36
While I recognize it's an attempt to highlight the "takeaway", the submission title (currently "Choosing Monday for a surgery increases your chance of success 2 times") seriously distorts the actual study contents.

It's not analyzing "success" of the surgery, but "30-day mortality for (almost) any cause". (While death caused by the surgery is definitely failure, the absence of death isn't necessarilt "success".)

Also, there's no evaluation of "consciously choosing Monday" as a causal factor. There could be all sorts of pressures causing the surgeries on different days-of-the-week to have different risk factors, even if they're all "elective". (As they note: "One of the weaknesses of using administrative data is that we were unable to completely adjust for inherent selection biases that probably exist for elective procedures that are scheduled on weekends.".)

I can believe there's some effect of patient choice, possibly related to staff exhaustion, post-op complications happening during under-resourced weekends, but expect a lot of the effect found here to be due to factors pushing certain surgeries/deaths into certain days (and arbitrary categories that might have affected inclusion).

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

#37

Pro tip: if getting a colonoscopy, always always get the first appointment of the day. I work in med devices and ummm those scopes still have poop left over between procedures. Its not harmful, but still...

I'm no expert but aren't you exposing one patient to the previous patient's poop? There could be anything from a lovely c-diff payload to something the next guy is allegeric to like nuts. As a layperson it hardly seems harmless.

I have a feeling OP means they are sterilized or autoclaved but some (now non-dangerous) particles remain as there is no medical point in thoroughly cleaning them after sterilization. Which would make sense.

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

#38
post #4

Earlier quoted context omitted.

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.

Has potential for the exact same selection bias as the judge study, you mean? See if we can discover some impossibly hungry programmers.

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

#39

Pro tip: if getting a colonoscopy, always always get the first appointment of the day. I work in med devices and ummm those scopes still have poop left over between procedures. Its not harmful, but still...

Why are they not cleaned thoroughly? Just curious.

And if they are and yet still contain fecal matter, how does going in the next day help? Your appointment is still after someone else's. Do they use a new scope?

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

#40

Pro tip: if getting a colonoscopy, always always get the first appointment of the day. I work in med devices and ummm those scopes still have poop left over between procedures. Its not harmful, but still...

I'm no expert but aren't you exposing one patient to the previous patient's poop? There could be anything from a lovely c-diff payload to something the next guy is allegeric to like nuts. As a layperson it hardly seems harmless.

The first (not sure if reputable) article I came across regarding this suggests that this is absolutely a major public health concern and maybe people working in medical devices passing it off as harmless is part of the problem...

https://www.focusforhealth.org/need-a-colonoscopy-the-one-qu...

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