title: Weekday vs. weekend repair of esophageal atresia and tracheoesophageal fistula.
abstract: OBJECTIVE
  We hypothesize that weekend esophageal atresia and tracheoesophageal fistula (EA/TEF) repair has worse outcomes compared to procedures performed on weekdays.
  
  
  METHODS
  Kids' Inpatient Database (1997-2009) was searched for EA/TEF in infants admitted at <8days of life. Cases were limited to patients who underwent repair during their hospitalization. Risk-adjusted multivariate analysis (MVA) compared complications, mortality, and resource utilization (length of stay [LOS] total charges [TC]) between weekday and weekend procedures.
  
  
  RESULTS
  Overall, 861 EA/TEF cases with known day of repair were identified. Cohort survival was 96%. On risk-adjusted MVA, complication rates were higher with EA/TEF repair on a weekend (OR: 2.2) compared to a weekday. Additionally, complications (OR: 6.5) and LOS (OR: 9.3) were found to be higher among African American children compared to Caucasians. LOS was higher in patients with Medicaid (OR: 2.4) and repairs performed at non-teaching hospitals (OR: 3.2). Weekend vs. weekday procedure had no significant effect on mortality or resource utilization.
  
  
  CONCLUSIONS
  By risk-adjusted MVA, increased complication rates for EA/TEF are seen in patients undergoing repair on weekends compared to weekdays. Additionally, African American children experienced higher complication rates compared to Caucasians. LOS after repair varies according to race, payer status, and hospital characteristics.
authors.affiliation: Division of Pediatric Surgery, DeWitt-Daughtry Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL.
authors.forename: Arash J
authors.initials: AJ
authors.lastname: Sayari
authors.affiliation: Division of Pediatric Surgery, DeWitt-Daughtry Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL.
authors.forename: Jun
authors.initials: J
authors.lastname: Tashiro
authors.affiliation: Division of Pediatric Surgery, DeWitt-Daughtry Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL.
authors.forename: Bo
authors.initials: B
authors.lastname: Wang
authors.affiliation: Division of Pediatric Surgery, DeWitt-Daughtry Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL.
authors.forename: Eduardo A
authors.initials: EA
authors.lastname: Perez
authors.affiliation: South Florida Pediatric Surgeons, P.A., Plantation, FL.
authors.forename: David S
authors.initials: DS
authors.lastname: Lasko
authors.affiliation: Division of Pediatric Surgery, DeWitt-Daughtry Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, FL. Electronic address: JSola@med.miami.edu.
authors.forename: Juan E
authors.initials: JE
authors.lastname: Sola
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D039602:After-Hours Care / Q000706:statistics & numerical data*; D004933:Esophageal Atresia / Q000191:economics / Q000208:ethnology / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000208:ethnology*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014138:Tracheoesophageal Fistula / Q000191:economics / Q000208:ethnology / Q000401:mortality / Q000601:surgery*; D014481:United States; D044465:White People / Q000706:statistics & numerical data
keywords: Esophageal atresia/tracheoesophageal fistula; Outcomes research; Tracheoesophageal fistula