Higher Mortality in Patients Undergoing Nighttime Surgical Procedures for Acute Type A Aortic Dissection

Abstract

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.

Acute type A aortic dissection in‐hours versus out‐of‐hours: A systematic review and meta‐analysis

“…Of these, 195 articles were excluded after the inclusion and exclusion criteria were applied. Full text of the remaining 45 papers was screened, yielding six studies to be included in the systematic review and meta‐analysis 8‐13 . The PRISMA flow chart illustrates these search results in Figure S1.…”

“…Other studies included in this systematic review did not adequately control and report on this factor. 8,10,11,13 Therefore, we acknowledge that these factors are potential confounders within this systematic review and could be further improved upon in future studies. 14,15,32 Overall, this study suggests that postoperative outcomes were comparable in IH and OOH surgery for ATAAD, with IH surgery being marginally superior for having lower 30-day mortality and AKI rates.…”

“…A sensitivity analysis was done by removing studies with a large cohort size (n > 1000) from the data analysis to determine whether these studies had biased our reported outcomes. When the sensitivity analysis was carried out, the 30-day mortality was found not to be significantly different between the OOH and IH cohorts (n = 180 Figure S11) despite each individual study [8][9][10][11][12][13] reporting lower 30-day mortality rates in the IH cohort as compared with the OOH cohort. This sensitivity analysis demonstrates that there is a potential bias in the reported 30-day mortality rate due to greater weightage given to studies with larger sample sizes in the metaanalysis, thus skewing the accuracy of its results.…”

“…Full text of the remaining 45 papers was screened, yielding six studies to be included in the systematic review and meta-analysis. [8][9][10][11][12][13] The PRISMA flow chart illustrates these search results in Figure S1. The characteristics of the included studies are summarized in Table 1.…”

“…There was no significant difference between the IH and OOH co- rate was found to be significantly lower in the IH cohort as compared with the OOH cohort (n = 621 in IH vs. n = 334 in OOH cohort; RR, 0.81; 95% CI [0.72, 0.90]; p = .0001; Figure 3). Also, some studies 9,13 found that the complication of AKI was significantly lower in the IH cohort as compared with the OOH cohort (n = 120 [27%] vs. n = 144…”