Impact of after-hours surgery on outcomes of acute type A aortic dissection repair

Takahashi, Baku; Kamohara, Keiji; Amamoto, Sojiro; Kawaguchi, Atsushı

doi:10.1007/s00595-022-02487-7

Cited by 3 publications

(9 citation statements)

References 34 publications

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“…In summary, 14 studies met the eligibility criteria for full-text review. 3) 4) 5) 6) 7) 8) 9) 10) 12) 13) 14) 19) 20) 21) The PRISMA flow diagram of article selection for meta-analysis is shown in Figure 1 . Detailed information, such as age, sex, total number of enrolled patients, and characteristics of the studies, are summarized in Supplementary Table 2 .…”

Section: Resultsmentioning

confidence: 99%

“…The total number of patients with TAAD surgery enrolled in the present meta-analysis was 16,501. 3) 4) 5) 6) 7) 8) 9) 10) 21) …”

Section: Resultsmentioning

confidence: 99%

“…Previous studies have examined the higher mortality risk among patients who underwent TAAD repair surgery during off-hours, such as during weekends, 3) 4) nighttime, 5) 6) and non-working hours. 7) However, worldwide evidence found the association between mortality risk and surgery time inconclusive. 8) 9) 10) Consequently, this gap remains unclear and needs to be addressed.…”

Section: Introductionmentioning

confidence: 99%

“…Recently, several new studies have investigated the effect of off-hours on the mortality outcomes of patients with TAAD, 3) 4) 5) 7) 8) 9) 10) 12) 13) 14) and the number of studies and sample size has expanded beyond what was included in previous systematic reviews and meta-analyses. 11) However, the association between off-hours surgery (including during weekend, nighttime, and non-working hours) and mortality among patients with TAAD remain inconclusive.…”

Section: Introductionmentioning

confidence: 99%

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Off-hours Surgery and Mortality in Patients With Type A Aortic Dissection Repair: A Systematic Review and Meta-Analysis

Liu,

Chang,

Hsu

et al. 2024

Korean Circ J

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Author's summary In a systematic review and meta-analysis of 16,501 participants, a notable 'weekend effect' emerged for type A aortic dissection (TAAD) repair surgeries. Patients operated on during weekends faced a 41% higher in-hospital mortality risk compared to weekdays, while nighttime surgeries showed no increased risk. The study challenges previous categorizations of "overall off-hours" and highlights non-surgical concerns, like staffing or resources, during weekends. These findings underscore the need for hospitals to address weekend-specific challenges and advocate for more research to ensure consistent, high-quality care for TAAD patients round-the-clock.

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Section: Resultsmentioning

confidence: 99%

“…The total number of patients with TAAD surgery enrolled in the present meta-analysis was 16,501. 3) 4) 5) 6) 7) 8) 9) 10) 21) …”

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Off-hours Surgery and Mortality in Patients With Type A Aortic Dissection Repair: A Systematic Review and Meta-Analysis

Liu,

Chang,

Hsu

et al. 2024

Korean Circ J

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“…Acute type A aortic dissection (ATAAD) remains a challenge and it is accompanied by high morbidity and mortality 1–4 . Nowadays, emergency cardiac surgery is recommended as the treatment of choice for ATAAD corrections 1–15 . Many patients with ATAAD present with malperfusion syndrome due to inadequate blood supply to target organs.…”

mentioning

confidence: 99%

Acute renal failure after acute type A aortic dissection repair. Insidious postoperative complication with poor short‐ and long‐term prognosis

Samanidis

Kanakis

Kourelis

et al. 2022

Journal of Cardiac Surgery

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Acute type A aortic dissection (ATAAD) is a life-threatening aortic disease. Many systems and organs are affected by malperfusion which presents preoperatively and postoperatively. Postoperative acute renal failure after ATAAD constitutes a severe and insidious complication. Acute renal damage is observed in many patients with ATAAD preoperatively and it burdens the renal function postoperatively. Renal replacement therapy represents an additional risk factor for short-, mid-, and longterm outcomes after ATAAD repair. Brown et al.'s present study highlight the clinical significance of this complication. Also, they remind us of the importance of optimizing perioperative renal protective strategies in patients undergoing ATAAD repair.

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Sex-Related Differences Between Patients Undergoing Surgery for Acute Type A Aortic Dissection

Takahashi,

Kamohara,

Morokuma

et al. 2024

Cureus

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Introduction This study aimed to evaluate the sex-specific characteristics and surgical outcomes in patients with acute type A aortic dissection (ATAAD). Materials and methods We reviewed the surgical records of patients who underwent ATAAD repair at our institution between 2004 and 2020 (n=213). Results Of the 213 patients, 100 (46.9%) were male, and 113 (53.1%) were female. Males were younger than females (62.5 vs. 72.9 years, p<0.0001). Females had more nonspecific symptoms (p=0.04), more frequently developed ATAAD before noon (45.0% vs. 53.1%, p=0.01), and had a significantly longer time from onset to surgery (425.1 vs. 595.8 min, p=0.03). The ascending aorta was replaced more frequently in females than in males (54.5% vs. 72.8%, p<0.01). No significant difference was observed in the in-hospital mortality rate between males and females (9.0% vs. 10.6%, p=0.69). The multivariable logistic analysis demonstrated that being male was not an independent predictor of operative mortality (OR, 0.96; 95% CI, 0.18-5.21; p=0.96). At 10 years, males had significantly better long-term survival rates in the unadjusted cohort than females (79.4% vs. 55.9%, p=0.02). Conclusions Male sex was not an independent predictor of early death in patients with ATAAD after surgery, although significant differences were noted in terms of age, onset time, chief complaint, imaging findings, and surgical procedures. A sex-based management strategy involving specific differences should be considered to improve outcomes.

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Impact of after-hours surgery on outcomes of acute type A aortic dissection repair

Cited by 3 publications

References 34 publications

Off-hours Surgery and Mortality in Patients With Type A Aortic Dissection Repair: A Systematic Review and Meta-Analysis

Off-hours Surgery and Mortality in Patients With Type A Aortic Dissection Repair: A Systematic Review and Meta-Analysis

Acute renal failure after acute type A aortic dissection repair. Insidious postoperative complication with poor short‐ and long‐term prognosis

Sex-Related Differences Between Patients Undergoing Surgery for Acute Type A Aortic Dissection

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