Comparison of nighttime and daytime operation on outcomes of supracondylar humeral fractures: A prospective observational study

Büget, Mehmet İlke; Canbolat, Nur; Chousein, Chasan Memet; Kızılkurt, Taha; Erşen, Ali; Koltka, Kemalettin

doi:10.1097/md.0000000000029382

Cited by 4 publications

(2 citation statements)

References 24 publications

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“…A study in thoracic surgery found that lung resections performed using a video-assisted thoracoscopic surgery approach (VATS) had a significantly higher incidence of intraoperative complications when performed during the night shift [ 51 ]. In a study by Buget et al of children operated on for supracondylar humerus fracture, better outcomes were found with daytime operations, with shorter operative time and lower morbidity than with nighttime operations [ 52 ]. Studies in various fields of abdominal surgery again supported the safety of daytime surgery [ 53 , 54 , 55 , 56 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes of Daytime Versus Nighttime Laparoscopic Appendectomy in Children

et al. 2023

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Aim of the study: To evaluate the clinical outcomes and complication rate of laparoscopic appendectomy in children operated on during the daytime versus nighttime. Methods: A total of 303 children who underwent laparoscopic appendectomy for acute appendicitis between 1 January 2020 and 31 December 2022 were enrolled in this retrospective study. The patients were divided into two study groups. The first group consisted of the patients who underwent laparoscopic appendectomy during the day shift from 07:00–21:00 (n = 171), while the patients in the second group underwent laparoscopic appendectomy during the night shift from 21:00–07:00 (n = 132). The groups were compared for baseline clinical and laboratory data, treatment outcomes, and complications. The Mann–Whitney U test was used to compare continuous variables, while the Chi-square test was used to compare categorical variables. A two-sided Fisher’s exact test was used when the frequency of events in a certain cell was low. All p values less than 0.05 were considered significant. Results: The proportion of complicated appendicitis was almost the same in both patient groups (n = 63, 36.8% vs. n = 49, 37.1%, p = 0.960). Out of the total number of patients presenting during the daytime and nighttime, 11 (6.4%) and 10 (7.6%) developed a postoperative complication, respectively (p = 0.697). Additionally, rates of readmission (n = 5 (2.9%) vs. n = 2 (1.5%); p = 0.703), redo-surgery (n = 3 (1.7%) vs. n = 0; p = 0.260), conversion to open surgery (n = 0 vs. n = 1 (0.8%); p = 0.435) and length of hospital stay (n = 3 (IQR 1, 5) vs. n = 3 (IQR 2, 5); p = 0.368) did not differ significantly between daytime and nighttime appendectomies. The duration of the surgery was significantly shorter in patients presenting during the day than in those presenting at night (26 min (IQR 22, 40) vs. 37 min (31, 46); p < 0.001). Conclusions: Different shift times did not affect the treatment outcomes or complication rates for children receiving laparoscopic appendectomy.

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Section: Discussionmentioning

confidence: 99%

Clinical Outcomes of Daytime Versus Nighttime Laparoscopic Appendectomy in Children

et al. 2023

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“…Reported data regarding the relative quantity of incidents occurring during different times of the day was collected as an additional parameter and cannot be used to draw any conclusions on this matter. Studies with methodology focused on this question report a higher rate of perioperative adverse events during nighttime surgery [ 23 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

Critical incidents during anesthesia: prospective audit

Bielka,

Kuchyn,

Frank

et al. 2023

BMC Anesthesiol

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Background Critical incident reporting and analysis is one of the key components of patient safety in anesthesiology. The aim of this study was to determine the frequency and characteristics of critical incidents during anesthesia, main causes and factors involved, influence on patient outcomes, prevalence of incident reporting and further analysis. Methods A multicenter prospective audit was conducted at the clinical departments of the Bogomolets National Medical University during the period from 1 to 2021 to 1 December 2021. 13 hospitals from different Ukrainian regions took part in the study. Anesthesiologists voluntarily submitted critical incident reports into a Google form as they occurred during the working shifts, reporting the details of the incident, and the incident registration routine in their hospital. The study design was approved by the Bogomolets National Medical University (NMU) ethics committee, protocol #148, 07.09.2021. Results The incidence of critical incidents was 9.35 cases per 1000 anesthetic procedures. Most common incidents were related to the respiratory system: difficult airway (26.8%), reintubation (6.4%), oxygen desaturation (13.8%); cardiovascular system: hypotension (14.9%), tachycardia (6.4%), bradycardia (11.7%), hypertension (5.3%), collapse (3.2%); massive hemorrhage (17%). Factors associated with critical incidents were elective surgery (OR 4.8 [3.1–7.5]), age from 45 to 75 years (OR 1.67 [1.1–2.5]), ASA II (OR 38 [13–106]}, III (OR 34 [12–98]) or IV (3.7 [1.2–11]) compared to ASA I; regional anesthesia (OR 0.67 95 CI 0.5–0.9) or general anesthesia (GA) and regional anesthesia combination (OR 0.55 95 CI 0.3–0.9] decreased the risk of incidents compared to GA alone. Procedural sedation was associated with increased risk of a critical incident, compared to GA (OR 0.55 95 CI 0.3–0.9). The incidents occurred most commonly during the maintenance phase (75/113, 40%, OR compared to extubation phase 20 95 CI 8–48) or the induction phases of anesthesia (70/118, 37%, OR compared to extubation phase 18 95 CI 7–43). Among common reasons that could lead to the incident, the physicians have identified: individual patient features (47%), surgical tactics (18%), anesthesia technique (16%) and human factor (12%). The most frequent failings contributing to the incident occurrence were: insufficient preoperative assessment (44%), incorrect interpretation of the patients’ state (33%), faulty manipulation technique (14%), miscommunication with a surgical team (13%) and delay in emergency care (10%). Furthermore, 48% of cases, as judged by participating physicians, were preventable and the consequences of another 18% could be minimized. The consequences of the incidents were insignificant in over a half of the cases, but in 24.5% have led to prolonged hospital stay, in 16% patients required an urgent transfer to the ICU and 3% of patients died during their hospital stay. The majority of the critical incidents (84%) were reported through the hospital reporting system, using mostly paper forms (65%), oral reports (15%) and an electronic database (4%). Conclusion Critical incidents during anesthesia occur rather often, mainly during the induction or maintenance phases of anesthesia, and could lead to prolonged hospital stay, unplanned transfer to the ICU or death. Reporting and further analysis of the incident are crucial, so we should continue to develop the web-based reporting systems on both local and national levels. Study registration NCT05435287, clinicaltrials.gov, 23/6/2022.

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Daytime versus nighttime appendectomy in term of complications and clinical outcomes: a meta-analysis

Tang,

Wang,

Chen

et al. 2024

Int J Colorectal Dis

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Background Appendicitis is one of the most common acute surgical conditions globally. However, the association between nighttime appendectomy and patients’ morbidity and mortality is unclear. This study aims to compare outcomes following nighttime versus daytime appendectomy. Methods The PubMed, Embase, Cochrane Library, and Web of Science databases up to March 26, 2024 (updated on July 1, 2024) were searched. The primary outcomes were postoperative complications and mortality. Secondary outcomes included intraoperative complications, reoperation, readmission, conversion to laparotomy, hospital stay and operation time. Mean difference (MD) or odds ratios (OR) and 95% confidence intervals were calculated. Results Fifteen studies totaling 33,596 patients were included. There were no differences between nighttime and daytime appendectomy for rates of overall postoperative complications (OR 0.93, 95% CI 0.87, 1.00, 14 studies), mortality (OR 1.70, 95% CI 0.37, 7.88, 7 studies), intraoperative complications (OR 0.88, 95% CI 0.08, 9.86; 2 studies), reoperation (OR 0.39, 95% CI 0.06, 2.55; 3 studies) and readmission (OR 0.86, 95% CI 0.65, 1.13; I 2 = 0%, 5 studies). However, the conversion to laparotomy risks (OR 1.92, 95% CI 1.12, 3.29; 6 studies) among patients who underwent appendectomy during nighttime was significantly elevated compared to daytime. Conclusions There was no increased risk or difference in postoperative mortality and complication rates associated with nighttime compared with daytime appendectomy. However, future studies should assess the reasons for higher conversion rates during the night. Supplementary Information The online version contains supplementary material available at 10.1007/s00384-024-04705-9.

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Comparison of nighttime and daytime operation on outcomes of supracondylar humeral fractures: A prospective observational study

Cited by 4 publications

References 24 publications

Clinical Outcomes of Daytime Versus Nighttime Laparoscopic Appendectomy in Children

Clinical Outcomes of Daytime Versus Nighttime Laparoscopic Appendectomy in Children

Critical incidents during anesthesia: prospective audit

Daytime versus nighttime appendectomy in term of complications and clinical outcomes: a meta-analysis

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