Operation Timing and 30-Day Mortality After Elective General Surgery

Sessler, Daniel I.; Kurz, Andrea; Saager, Leif; Dalton, Jarrod E.

doi:10.1213/ane.0b013e3182315a6d

Cited by 46 publications

(37 citation statements)

References 30 publications

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“…(10–12) In contrast, Sessler found no correlation between a composite complication score after general surgery and case start time by using the United States Agency for Healthcare Research and Quality’s Clinical Classifications Software (AHRQ-CCS). (13…”

Section: Discussionmentioning

confidence: 99%

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Factors That Correlate With the Decision to Delay Extubation After Multilevel Prone Spine Surgery

Anastasian¹,

Gaudet²,

Levitt

et al. 2014

Journal of Neurosurgical Anesthesiology

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Background Multi-level spinal decompressions and fusions often require long anesthetic and operative times which may result in airway edema and prolonged post-operative intubation. Delayed extubation can lead to broncho-pulmonary infections and other complications. This study analyzed which factors correlated with the decision to delay extubation after multilevel spine surgery. Methods We reviewed the records of 289 patients having multilevel spine surgery lasting 8 hours or more in the prone position from 2006 to 2012. Variables hypothesized to affect the decision of the anesthesiologist to delay extubation at the end of the surgery were collected. These included preoperative factors (age, gender, ASA Class, history of obstructive sleep apnea, BMI, previous spine surgery, current cervical surgery, anterior in addition to posterior spine surgery, emergency surgery), and intraoperative factors (difficult intubation, number of surgical levels, case time, estimated blood loss, fluid and blood administration, attending handoff and resident handoff, and case end time). We also compared the incidence of pulmonary post-operative complications between patients extubated at the end of the case to patients who had a delayed extubation. Results 126 patients (44%) were kept intubated after multilevel spine surgery. Multiple linear regression analysis showed factors that correlated with prolonged intubation included age, ASA Class, procedure duration, extent of surgery, total crystalloid volume administered, total blood volume administered, and the case end time. Patients who had a delayed extubation had a threefold higher rate of post-operative pneumonia. Conclusions Our study finds that age, ASA class, procedure duration, extent of surgery, and total crystalloid and blood volume administered correlate with the decision to delay extubation in multilevel prone spine surgery. It also finds that the time that the case ends is an independent variable that correlates with the decision not to extubate at the end of a long multi-level spinal surgery. The incidence of post-operative pneumonia is higher in patients who had a delayed extubation after surgery.

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Section: Discussionmentioning

confidence: 99%

“…(14) No difference in mortality was found in an academic setting having non-emergent surgery with evening start times when controlling for patient factors. (13, 15) Transplant patients having evening surgery have the same mortality to those performed during daytime hours. (12, 16)…”

Section: Discussionmentioning

confidence: 99%

Factors That Correlate With the Decision to Delay Extubation After Multilevel Prone Spine Surgery

Anastasian¹,

Gaudet²,

Levitt

et al. 2014

Journal of Neurosurgical Anesthesiology

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show abstract

“…A single-center study analyzing 32,001 elective general surgical patients showed a trend toward increasing mortality and complications as the day progressed from 6 am to 6 pm; however, these differences were not significant. 15 Results from studies on cardiac surgery and orthopedic surgery showed comparable outcomes between surgeries performed during the day and during the night. 13,16 Trauma surgery, however, is unique in that it is always emergent and is performed at all times of the day.…”

Section: Commentsmentioning

confidence: 97%

The sleepy surgeon: does night-time surgery for trauma affect mortality outcomes?

Zafar

Libuit

Hashmi

et al. 2015

The American Journal of Surgery

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“…They could not demonstrate any differences between weekday, time of day or different months concerning 30-day mortality, concluding that surgery was safe on any day and any time of the week [21].…”

Section: Week Day Percentagementioning

confidence: 90%

Influence of Weekday of Surgery on Operative Complications. An Analysis of 25.000 Surgical Procedures

Müller¹,

Strauchmann²,

Katou³

et al. 2017

Clin Res Trial

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Background: Surgical procedures need to be performed safely on every day and night of the week. Operations on certain weekdays have recently been shown to be associated with increased risk. Patient concerns about their safety have to be taken seriously when surgery needs to be planned. Many patients also believe in negative effects of lunar constellations or Friday 13 th . To establish a scientific basis for reassurement, we retrospectively analyzed surgical complications at a maximum care center, addressing these issues.

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Operation Timing and 30-Day Mortality After Elective General Surgery

Abstract: Elective general surgery appears to be comparably safe at any time of the workday, any day of the workweek, and in any month of the year.

Cited by 46 publications

References 30 publications

Factors That Correlate With the Decision to Delay Extubation After Multilevel Prone Spine Surgery

Factors That Correlate With the Decision to Delay Extubation After Multilevel Prone Spine Surgery

The sleepy surgeon: does night-time surgery for trauma affect mortality outcomes?

Influence of Weekday of Surgery on Operative Complications. An Analysis of 25.000 Surgical Procedures

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