Abstract:ObjectiveTreatment of acute diseases of the aorta is still associated with high mortality and morbidity. It is believed that interventions for these diseases on overtime hours (night shifts or weekend shifts) may increase mortality. In this study, we investigated the effect of performing acute type A aortic dissection surgery on overtime hours in terms of postoperative outcomes.Methods206 patients who underwent emergency surgery for acute type A aortic dissection were retrospectively evaluated. Two groups were… Show more
“…We also explored the possibility of surgical teams having differing levels of experience in the IH and OOH groups. We noted that although Gokalp et al 9 was able to ensure that patients in both cohorts were operated by teams with similar levels of surgical experience, Narayan et al 12 were unable to account for the differences in surgical experience between the two groups in their study. Other studies included in this systematic review did not adequately control and report on this factor 8,10,11,13 .…”
Section: Discussionmentioning
confidence: 88%
“…In contrast, 30‐day mortality 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 [31%]; RR, 0.80; 95% CI [0.65, 0.98]; p = .03, Figure S9). Only two studies 9,10 reported the total hospital stay and this was not different between the IH and OOH cohorts, 11.5 ± 12.5 in IH versus 11.0 ± 14.0 in OOH (WMD, 0.71; 95% CI [−2.20, 3.62]; p = .63; Figure 4).…”
Section: Resultsmentioning
confidence: 99%
“…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…”
Section: Postoperative Outcomesmentioning
confidence: 99%
“…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.…”
Section: Sensitivity Analysismentioning
confidence: 99%
“…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.…”
Objective: We sought to compare clinical outcomes in patients with acute type A aortic dissection that undergone surgical repair during in-hours (IH) versus out-ofhours (OOH). Methods: An electronic literature search was done till March 2020 to include studies with comparative cohorts of IH versus OOH. Primary outcomes were 30-day mortality, stroke, and reoperation for bleeding; secondary outcomes were acute kidney injury, total hospital stay, and intensive care unit stay. Results: Six articles with a total of 3744 patients met the inclusion criteria. Mean age was similar, 60 ± 12 versus 60 ± 13 in IH versus OOH (p = .25). Aortic root and total arch replacement were similar in both cohorts, 22% in IH versus 25% in OOH
“…We also explored the possibility of surgical teams having differing levels of experience in the IH and OOH groups. We noted that although Gokalp et al 9 was able to ensure that patients in both cohorts were operated by teams with similar levels of surgical experience, Narayan et al 12 were unable to account for the differences in surgical experience between the two groups in their study. Other studies included in this systematic review did not adequately control and report on this factor 8,10,11,13 .…”
Section: Discussionmentioning
confidence: 88%
“…In contrast, 30‐day mortality 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 [31%]; RR, 0.80; 95% CI [0.65, 0.98]; p = .03, Figure S9). Only two studies 9,10 reported the total hospital stay and this was not different between the IH and OOH cohorts, 11.5 ± 12.5 in IH versus 11.0 ± 14.0 in OOH (WMD, 0.71; 95% CI [−2.20, 3.62]; p = .63; Figure 4).…”
Section: Resultsmentioning
confidence: 99%
“…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…”
Section: Postoperative Outcomesmentioning
confidence: 99%
“…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.…”
Section: Sensitivity Analysismentioning
confidence: 99%
“…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.…”
Objective: We sought to compare clinical outcomes in patients with acute type A aortic dissection that undergone surgical repair during in-hours (IH) versus out-ofhours (OOH). Methods: An electronic literature search was done till March 2020 to include studies with comparative cohorts of IH versus OOH. Primary outcomes were 30-day mortality, stroke, and reoperation for bleeding; secondary outcomes were acute kidney injury, total hospital stay, and intensive care unit stay. Results: Six articles with a total of 3744 patients met the inclusion criteria. Mean age was similar, 60 ± 12 versus 60 ± 13 in IH versus OOH (p = .25). Aortic root and total arch replacement were similar in both cohorts, 22% in IH versus 25% in OOH
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