title: The weekend effect: does time of admission impact management and outcomes of small bowel obstruction?
abstract: OBJECTIVE
  To determine whether day and time of admission influences the practice patterns of the admitting general surgeon and subsequent outcomes for patients diagnosed with small bowel obstruction.
  
  
  METHODS
  A retrospective database review was carried out, covering patients admitted with the presumed diagnosis of partial small bowel obstruction from 2004-2011.
  
  
  RESULTS
  A total of 404 patients met the inclusion criteria. One hundred and thirty-nine were admitted during the day, 93 at night and 172 on the weekend. Overall 30.2% of the patients were managed operatively with no significant difference between the groups (P = 0.89); however, of patients taken to the operating room, patients admitted during the day received operative intervention over 24 hours earlier than those admitted at a weekend, 0.79 days vs 1.90 days, respectively (P = 0.05). Overall mortality was low at 1.7%, with no difference noted between the groups (P = 0.35). Likewise there was no difference in morbidity rates between the three groups (P = 0.90).
  
  
  CONCLUSIONS
  Despite a faster time to operative intervention in those patients admitted during the day, our study revealed that time of admission does not appear to correlate to patient outcome or mortality.
authors.affiliation: Department of Surgery, Madigan Healthcare System, Tacoma, WA, USA.
authors.forename: Derek P
authors.initials: DP
authors.lastname: McVay
authors.affiliation: Department of Surgery, Madigan Healthcare System, Tacoma, WA, USA.
authors.forename: Avery S
authors.initials: AS
authors.lastname: Walker
authors.affiliation: Department of Surgery, Madigan Healthcare System, Tacoma, WA, USA.
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Nelson
authors.affiliation: Department of Surgery, Madigan Healthcare System, Tacoma, WA, USA.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Porta
authors.affiliation: Department of Surgery, Madigan Healthcare System, Tacoma, WA, USA.
authors.forename: Marlin W
authors.initials: MW
authors.lastname: Causey
authors.affiliation: Department of Surgery, Madigan Healthcare System, Tacoma, WA, USA tommy.brown@us.army.mil.
authors.forename: Tommy A
authors.initials: TA
authors.lastname: Brown
keywords: outcomes; small bowel obstruction; time of admission; weekend effect