Surgery Start Time Does Not Impact Outcome in Elective Cardiac Surgery

Heller, Joshua A.; Kothari, Rishi; Lin, Hung‐Mo; Levin, Matthew A.; Weiner, Menachem M.

doi:10.1053/j.jvca.2016.08.015

Cited by 30 publications

(37 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Worse postoperative outcomes for procedures starting outside the regular working hours have also been attributed to care transitions with consecutive information losses, lack of availability of specialists, less familiarity with the procedure, greater dependence on residents and unbefitting staffing [25]. Several subspecialties have specifically addressed these shortcomings by providing specialized care round the clock and hence guaranteeing the same standard of care and procedural outcome even during after hours [27]. This holds most likely also true for the majority of transplant centers, which could explain why the majority of the studies included in our review could not demonstrate a negative effect of performing transplant procedures after hours on outcome.…”

Section: Discussionmentioning

confidence: 99%

Outcome of transplantation performed outside the regular working hours: A systematic review and meta-analysis of the literature

Hendrikx

Raemdonck

Pirenne

et al. 2018

Transplantation Reviews

View full text Add to dashboard Cite

Transplant procedures are frequently performed outside the regular working hours (after hours). In general surgery, several studies observed worse outcomes for operations performed after hours. The predetermined hypothesis was that patients undergoing transplantation during after hours might suffer from an excess in post-operative mortality and morbidity when compared to patients undergoing transplantations during the regular working hours. A systematic review of the PubMed database identified 11,993 records, of which eleven cohort studies including a total of 287,741 patients investigated the association between the starting time of transplant surgery and postoperative mortality (primary outcome) and/or morbidity (secondary outcome). Eight studies evaluated kidney transplants (in 165,277 patients), two studies analyzed liver transplants (in 95,346 patients), and one study investigated transplantations of thoracic organs (in 27,118 patients). Results were conflicting with two studies (in liver and lung transplantation) showing an increased mortality for transplantations performed after hours, and five studies showing no effects on mortality. A meta-analysis on estimates from four studies yielded a hazard ratio of 1.01 (95% CI, 0.98 to 1.04) for mortality comparing transplantations performed during versus outside the regular working hours. The evidence was also inconclusive for a variety of morbidity outcomes with studies demonstrating either a deterioration of outcome, no effect or an improved outcome for after hours procedures. On the basis of the available evidence, it appears impossible to give an unequivocal recommendation regarding starting times in transplant surgery.

show abstract

Section: Discussionmentioning

confidence: 99%

Outcome of transplantation performed outside the regular working hours: A systematic review and meta-analysis of the literature

Hendrikx

Raemdonck

Pirenne

et al. 2018

Transplantation Reviews

View full text Add to dashboard Cite

show abstract

“…[10][11][12] Similarly, surgery during the daytime had fewer complications than at nighttime. 20,21 Workload and fatigue may be major contributors to these outcomes. China is a populous country and has the largest number of gastric cancer patients worldwide.…”

Section: Discussionmentioning

confidence: 99%

Effect of Time (Season, Surgical Starting Time, Waiting Time) on Patients with Gastric Cancer

Peng

Zou

Cheng

et al. 2021

RMHP

View full text Add to dashboard Cite

The purpose of the present study was to evaluate the effect of time (season, surgical starting time in the daytime, preoperative waiting time) on patients with gastric cancer. Methods: A retrospective collection of medical records of patients who underwent gastrectomy at a single clinical center from January 2013 to December 2018 was performed. Medical records were collected, and short-term outcomes and long-term survival were analyzed by different time groups. Results: A total of 586 patients were included in this study. In terms of surgical starting time, the midday group had a shorter operation time (p=0.017) but more complications (p=0.048) than the non-midday group. No significant difference was found based on the season of gastrectomy. The long preoperative waiting group had a shorter postoperative hospital stay than the short waiting group (p=0.026). No significant difference was found between the short-waiting group and long-waiting group in overall survival for all clinical stages. Age (p=0.040, HR=1.017, 95% CI=1.001-1.033), BMI (p<0.001, HR=0.879, 95% CI=0.844-0.953) and clinical stage (p<0.001, HR=2.053, 95% CI=1.619-2.603) were independent prognostic factors predicting overall survival; however, season of gastrectomy, surgical starting time and preoperative waiting time were not identified as independent prognostic factors. Conclusion: Surgical starting time at the midday could cause more complications, and surgeons should be careful when the surgical starting time is midday.

show abstract

“…We would like to thank Dr. Grocott 1 for his comments regarding our single-center, retrospective study that examined the effect of surgical start time upon morbidity and mortality in patients undergoing elective cardiac surgery, which did not find significant differences. 2 While we attempted to account for differences in patient demographics and medical comorbidities between groups, Dr. Grocott astutely observes that day of the week was not factored in to our study.…”

Section: Referencementioning

confidence: 99%

“…MR is a valvular pathology influenced by multiple variables such as preload, afterload, heart rhythm, and left ventricular contractility. 1,2 In the ambulatory setting, these variables are at baseline, and MR grading in a spontaneously ventilating patient can be assessed with minimal confounding. In the operating room, under GA and positive pressure ventilation, multiple hemodynamic variables are altered.…”

Section: Intraoperative Grading Of Mitral Regurgitation During Generamentioning

confidence: 99%

In Reply to “Letter to the Editor: Surgical Start Times and Outcomes: It’s Not Just the Hour, but the Day as Well”

Heller

Weiner

2018

Journal of Cardiothoracic and Vascular Anesthesia

Self Cite

View full text Add to dashboard Cite

Surgery Start Time Does Not Impact Outcome in Elective Cardiac Surgery

Cited by 30 publications

References 17 publications

Outcome of transplantation performed outside the regular working hours: A systematic review and meta-analysis of the literature

Outcome of transplantation performed outside the regular working hours: A systematic review and meta-analysis of the literature

Effect of Time (Season, Surgical Starting Time, Waiting Time) on Patients with Gastric Cancer

In Reply to “Letter to the Editor: Surgical Start Times and Outcomes: It’s Not Just the Hour, but the Day as Well”

Contact Info

Product

Resources

About