Higher Mortality in Patients Undergoing Nighttime Surgical Procedures for Acute Type A Aortic Dissection
The aim of this study was to investigate whether nighttime surgical procedures contribute to higher in-hospital mortality in patients with acute type A aortic dissection. All patients with acute type A aortic dissection who underwent surgical procedures at Fuwai Hospital in Beijing, China from 2010...
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| Veröffentlicht in: | The Annals of thoracic surgery 2018-10, Vol.106 (4), p.1164-1170 |
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| container_title | The Annals of thoracic surgery |
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| creator | Qiu, Juntao Zhang, Liang Luo, Xinjin Gao, Wei Liu, Shen Jiang, Wenxiang Wu, Jinlin Yu, Cuntao |
| description | The aim of this study was to investigate whether nighttime surgical procedures contribute to higher in-hospital mortality in patients with acute type A aortic dissection.
All patients with acute type A aortic dissection who underwent surgical procedures at Fuwai Hospital in Beijing, China from 2010 to 2015 were included in the present study. Depending on the start and end time of the surgical procedures, patients were divided in daytime and nighttime groups. Propensity-matching analysis was used to compare in-hospital mortality and postoperative complications between these groups.
A total of 698 patients with acute type A aortic dissection underwent operation. Of these, 321 (45.98%) patients underwent nighttime surgical procedures, whereas 377 (54.02%) patients underwent daytime procedures. The operation time, cardiopulmonary bypass time, and aortic cross-clamp time showed statistical differences between the two groups (p < 0.01). There was a significant difference between the daytime and nighttime groups in in-hospital mortality (6.42% vs 12.08%; p < 0.05). The nighttime group had a higher incidence rate of reintubation and continuous renal replacement therapy compared with the daytime group (p < 0.05). Furthermore, patients who underwent nighttime operations had significantly higher adjusted in-hospital mortality than patients who underwent daytime operations (odds ratio, 2.13; 95% confidence interval, 1.19 to 3.81; p = 0.01).
Patients with acute type A aortic dissection and certain serious medical conditions were more likely to die in the hospital if they underwent emergency nighttime surgical procedures. |
| doi_str_mv | 10.1016/j.athoracsur.2018.04.062 |
| format | Article |
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All patients with acute type A aortic dissection who underwent surgical procedures at Fuwai Hospital in Beijing, China from 2010 to 2015 were included in the present study. Depending on the start and end time of the surgical procedures, patients were divided in daytime and nighttime groups. Propensity-matching analysis was used to compare in-hospital mortality and postoperative complications between these groups.
A total of 698 patients with acute type A aortic dissection underwent operation. Of these, 321 (45.98%) patients underwent nighttime surgical procedures, whereas 377 (54.02%) patients underwent daytime procedures. The operation time, cardiopulmonary bypass time, and aortic cross-clamp time showed statistical differences between the two groups (p < 0.01). There was a significant difference between the daytime and nighttime groups in in-hospital mortality (6.42% vs 12.08%; p < 0.05). The nighttime group had a higher incidence rate of reintubation and continuous renal replacement therapy compared with the daytime group (p < 0.05). Furthermore, patients who underwent nighttime operations had significantly higher adjusted in-hospital mortality than patients who underwent daytime operations (odds ratio, 2.13; 95% confidence interval, 1.19 to 3.81; p = 0.01).
Patients with acute type A aortic dissection and certain serious medical conditions were more likely to die in the hospital if they underwent emergency nighttime surgical procedures.</description><identifier>ISSN: 0003-4975</identifier><identifier>EISSN: 1552-6259</identifier><identifier>DOI: 10.1016/j.athoracsur.2018.04.062</identifier><identifier>PMID: 29807008</identifier><language>eng</language><publisher>Netherlands: Elsevier Inc</publisher><subject>Acute Disease ; After-Hours Care ; Age Factors ; Aged ; Aneurysm, Dissecting - diagnostic imaging ; Aneurysm, Dissecting - mortality ; Aneurysm, Dissecting - surgery ; Aortic Aneurysm, Thoracic - diagnostic imaging ; Aortic Aneurysm, Thoracic - mortality ; Aortic Aneurysm, Thoracic - surgery ; Cause of Death ; China ; Cohort Studies ; Female ; Hospital Mortality - trends ; Humans ; Incidence ; Japan ; Kaplan-Meier Estimate ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Retrospective Studies ; Risk Assessment ; Sex Factors</subject><ispartof>The Annals of thoracic surgery, 2018-10, Vol.106 (4), p.1164-1170</ispartof><rights>2018 The Society of Thoracic Surgeons</rights><rights>Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c424t-846268c226ccb14ef069511c0c116a4a16eae2ea6c344598ae8e3baa443e3ef73</citedby><cites>FETCH-LOGICAL-c424t-846268c226ccb14ef069511c0c116a4a16eae2ea6c344598ae8e3baa443e3ef73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29807008$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Qiu, Juntao</creatorcontrib><creatorcontrib>Zhang, Liang</creatorcontrib><creatorcontrib>Luo, Xinjin</creatorcontrib><creatorcontrib>Gao, Wei</creatorcontrib><creatorcontrib>Liu, Shen</creatorcontrib><creatorcontrib>Jiang, Wenxiang</creatorcontrib><creatorcontrib>Wu, Jinlin</creatorcontrib><creatorcontrib>Yu, Cuntao</creatorcontrib><title>Higher Mortality in Patients Undergoing Nighttime Surgical Procedures for Acute Type A Aortic Dissection</title><title>The Annals of thoracic surgery</title><addtitle>Ann Thorac Surg</addtitle><description>The aim of this study was to investigate whether nighttime surgical procedures contribute to higher in-hospital mortality in patients with acute type A aortic dissection.
All patients with acute type A aortic dissection who underwent surgical procedures at Fuwai Hospital in Beijing, China from 2010 to 2015 were included in the present study. Depending on the start and end time of the surgical procedures, patients were divided in daytime and nighttime groups. Propensity-matching analysis was used to compare in-hospital mortality and postoperative complications between these groups.
A total of 698 patients with acute type A aortic dissection underwent operation. Of these, 321 (45.98%) patients underwent nighttime surgical procedures, whereas 377 (54.02%) patients underwent daytime procedures. The operation time, cardiopulmonary bypass time, and aortic cross-clamp time showed statistical differences between the two groups (p < 0.01). There was a significant difference between the daytime and nighttime groups in in-hospital mortality (6.42% vs 12.08%; p < 0.05). The nighttime group had a higher incidence rate of reintubation and continuous renal replacement therapy compared with the daytime group (p < 0.05). Furthermore, patients who underwent nighttime operations had significantly higher adjusted in-hospital mortality than patients who underwent daytime operations (odds ratio, 2.13; 95% confidence interval, 1.19 to 3.81; p = 0.01).
Patients with acute type A aortic dissection and certain serious medical conditions were more likely to die in the hospital if they underwent emergency nighttime surgical procedures.</description><subject>Acute Disease</subject><subject>After-Hours Care</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Aneurysm, Dissecting - diagnostic imaging</subject><subject>Aneurysm, Dissecting - mortality</subject><subject>Aneurysm, Dissecting - surgery</subject><subject>Aortic Aneurysm, Thoracic - diagnostic imaging</subject><subject>Aortic Aneurysm, Thoracic - mortality</subject><subject>Aortic Aneurysm, Thoracic - surgery</subject><subject>Cause of Death</subject><subject>China</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>Hospital Mortality - trends</subject><subject>Humans</subject><subject>Incidence</subject><subject>Japan</subject><subject>Kaplan-Meier Estimate</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Sex Factors</subject><issn>0003-4975</issn><issn>1552-6259</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkMtOwzAQRS0EgvL4BeQlm4Sx47jJsjyLxEuirC3XnbSu0rjYDlL_HqMWWLIajebcGc0hhDLIGTB5ucx1XDivTeh9zoFVOYgcJN8jA1aWPJO8rPfJAACKTNTD8ogch7BMLU_jQ3LE6wqGANWALMZ2vkBPn5yPurVxQ21HX3W02MVA37sZ-rmz3Zw-Jy5Gu0L61vu5Nbqlr94ZnPUeA22cpyPTR6STzRrpiI7SPmvojQ0BTbSuOyUHjW4Dnu3qCXm_u51cj7PHl_uH69FjZgQXMauE5LIynEtjpkxgA7IuGTNgGJNaaCZRI0ctTSFEWVcaKyymWgtRYIHNsDghF9u9a-8-egxRrWww2La6Q9cHxUFICbJgPKHVFjXeheCxUWtvV9pvFAP17Vkt1Z9n9e1ZgVDJc4qe76700xXOfoM_YhNwtQUw_fpp0atgktPky_okRM2c_f_KFy93lSg</recordid><startdate>201810</startdate><enddate>201810</enddate><creator>Qiu, Juntao</creator><creator>Zhang, Liang</creator><creator>Luo, Xinjin</creator><creator>Gao, Wei</creator><creator>Liu, Shen</creator><creator>Jiang, Wenxiang</creator><creator>Wu, Jinlin</creator><creator>Yu, Cuntao</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201810</creationdate><title>Higher Mortality in Patients Undergoing Nighttime Surgical Procedures for Acute Type A Aortic Dissection</title><author>Qiu, Juntao ; Zhang, Liang ; Luo, Xinjin ; Gao, Wei ; Liu, Shen ; Jiang, Wenxiang ; Wu, Jinlin ; Yu, Cuntao</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c424t-846268c226ccb14ef069511c0c116a4a16eae2ea6c344598ae8e3baa443e3ef73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Acute Disease</topic><topic>After-Hours Care</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Aneurysm, Dissecting - diagnostic imaging</topic><topic>Aneurysm, Dissecting - mortality</topic><topic>Aneurysm, Dissecting - surgery</topic><topic>Aortic Aneurysm, Thoracic - diagnostic imaging</topic><topic>Aortic Aneurysm, Thoracic - mortality</topic><topic>Aortic Aneurysm, Thoracic - surgery</topic><topic>Cause of Death</topic><topic>China</topic><topic>Cohort Studies</topic><topic>Female</topic><topic>Hospital Mortality - trends</topic><topic>Humans</topic><topic>Incidence</topic><topic>Japan</topic><topic>Kaplan-Meier Estimate</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Sex Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Qiu, Juntao</creatorcontrib><creatorcontrib>Zhang, Liang</creatorcontrib><creatorcontrib>Luo, Xinjin</creatorcontrib><creatorcontrib>Gao, Wei</creatorcontrib><creatorcontrib>Liu, Shen</creatorcontrib><creatorcontrib>Jiang, Wenxiang</creatorcontrib><creatorcontrib>Wu, Jinlin</creatorcontrib><creatorcontrib>Yu, Cuntao</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Annals of thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Qiu, Juntao</au><au>Zhang, Liang</au><au>Luo, Xinjin</au><au>Gao, Wei</au><au>Liu, Shen</au><au>Jiang, Wenxiang</au><au>Wu, Jinlin</au><au>Yu, Cuntao</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Higher Mortality in Patients Undergoing Nighttime Surgical Procedures for Acute Type A Aortic Dissection</atitle><jtitle>The Annals of thoracic surgery</jtitle><addtitle>Ann Thorac Surg</addtitle><date>2018-10</date><risdate>2018</risdate><volume>106</volume><issue>4</issue><spage>1164</spage><epage>1170</epage><pages>1164-1170</pages><issn>0003-4975</issn><eissn>1552-6259</eissn><abstract>The aim of this study was to investigate whether nighttime surgical procedures contribute to higher in-hospital mortality in patients with acute type A aortic dissection.
All patients with acute type A aortic dissection who underwent surgical procedures at Fuwai Hospital in Beijing, China from 2010 to 2015 were included in the present study. Depending on the start and end time of the surgical procedures, patients were divided in daytime and nighttime groups. Propensity-matching analysis was used to compare in-hospital mortality and postoperative complications between these groups.
A total of 698 patients with acute type A aortic dissection underwent operation. Of these, 321 (45.98%) patients underwent nighttime surgical procedures, whereas 377 (54.02%) patients underwent daytime procedures. The operation time, cardiopulmonary bypass time, and aortic cross-clamp time showed statistical differences between the two groups (p < 0.01). There was a significant difference between the daytime and nighttime groups in in-hospital mortality (6.42% vs 12.08%; p < 0.05). The nighttime group had a higher incidence rate of reintubation and continuous renal replacement therapy compared with the daytime group (p < 0.05). Furthermore, patients who underwent nighttime operations had significantly higher adjusted in-hospital mortality than patients who underwent daytime operations (odds ratio, 2.13; 95% confidence interval, 1.19 to 3.81; p = 0.01).
Patients with acute type A aortic dissection and certain serious medical conditions were more likely to die in the hospital if they underwent emergency nighttime surgical procedures.</abstract><cop>Netherlands</cop><pub>Elsevier Inc</pub><pmid>29807008</pmid><doi>10.1016/j.athoracsur.2018.04.062</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Acute Disease After-Hours Care Age Factors Aged Aneurysm, Dissecting - diagnostic imaging Aneurysm, Dissecting - mortality Aneurysm, Dissecting - surgery Aortic Aneurysm, Thoracic - diagnostic imaging Aortic Aneurysm, Thoracic - mortality Aortic Aneurysm, Thoracic - surgery Cause of Death China Cohort Studies Female Hospital Mortality - trends Humans Incidence Japan Kaplan-Meier Estimate Logistic Models Male Middle Aged Multivariate Analysis Retrospective Studies Risk Assessment Sex Factors |
| title | Higher Mortality in Patients Undergoing Nighttime Surgical Procedures for Acute Type A Aortic Dissection |
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