Comparison of daytime and after-hours surgical treatment of supracondylar humeral fractures in children

Abstract

therapeutic study (retrospective comparative study), Level III.

After-hours elective spine deformity corrective surgery for patients with Adolescent Idiopathic Scoliosis: Is it safe?

“…There were studies that documented surgeries done afterhours carried higher morbidity and mortality. [3][4][5][6][7][8][9][10][11] Chacko et al 3 performed a retrospective study of 767 consecutive patients with intertrochanteric, subtrochanteric, or femoral neck fractures and found that the duration of surgery, blood loss, and postoperative mortalities were significantly less for surgery done during the day compared with night. Ricci et al 4 conducted a prospective study among 203 patients with femur and tibia fractures comparing surgeries done at daytime and after-hours.…”

“…They concluded that daytime surgery has the potential to reduce minor complication rates for intramedullary nail fixation. Aydogmus et al 5 found that among 91 patients with Gartland type 3 fractures, pediatric supracondylar humerus fractures, after-hours surgery resulted Journal of Orthopaedic Surgery 27 (2) in higher poor fixation rate compared with daytime surgery. Kelz et al 6 reported a retrospective study of 144,740 nonemergent general and vascular surgical procedures, comparing the operation start time of 7 a.m. to 4 p.m., 4 p.m. to 6 p.m., and 6 p.m. to 11 p.m. and found that morbidity was significant higher when the operation start time was later in the day.…”

“…They concluded that daytime surgery has the potential to reduce minor complication rates for intramedullary nail fixation. Aydogmus et al 5 found that among 91 patients with Gartland type 3 fractures, pediatric supracondylar humerus fractures, after-hours surgery resulted…”

“…Surgeries performed between 08:00 and 16:59 h were labeled as daytime surgeries (group 1) and surgeries performed between 17:00 and 06:00 h were labeled as after-hours surgeries (group 2). 5,13 This distinction was made based on the starting time of the surgery. There were no specific criteria or distinction on how the patients were listed as patients were scheduled serially on the next available time slot for surgery whether it was daytime or after-hours.…”

“…However, studies had reported that surgeries that were done after-hours led to higher morbidity and mortality. [3][4][5][6][7][8][9][10][11] This was perceived that the poorer outcome of after-hours surgeries may be attributed to surgeon fatigue, lack of availability of support staffs, and other logistical facilities and resource factors. 3,6 However, all of these studies were either retrospective studies or studies which included patients who needed emergency surgeries or patients with fractures and other conditions whom were hospitalized for semi-emergency surgeries.…”