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Is There a Weekend ...
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Ahlsson, AndersKarolinska Institutet
(author)
Is There a Weekend Effect in Surgery for Type A Dissection? : Results From the Nordic Consortium for Acute Type A Aortic Dissection Database
- Article/chapterEnglish2019
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Elsevier,2019
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printrdacarrier
Numbers
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LIBRIS-ID:oai:DiVA.org:oru-76177
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https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-76177URI
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https://doi.org/10.1016/j.athoracsur.2019.03.005DOI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:141667319URI
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https://gup.ub.gu.se/publication/282810URI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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Funding Agencies:University of Iceland Research Fund, Reykjavik Landspitali Research Fund, Reykjavik Mats Kleberg Foundation, Stockholm
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Background: Aortic dissection type A requires immediate surgery. In general surgery populations, patients operated on during weekends have higher mortality rates compared with patients whose operations occur on weekdays. The weekend effect in aortic dissection type A has not been studied in detail.Methods: The Nordic Consortium for Acute Type A Aortic Dissection (NORCAAD) registry includes data for 1,159 patients who underwent type A dissection surgery at 8 Nordic centers during 2005 to 2014. This study is based on data relating to surgery conducted during weekdays versus weekends and starting between 8:00 AM and 8:00 Pm ("daytime") versus from 8:00 Pm to 8:00 AM ("nighttime"), as well as time from symptoms, admittance, and diagnosis to surgery. The influence of timing of surgery on the 30-day mortality rate was assessed using logistic regression analysis.Results: The 30-day mortality was 18% (204 of 1,159), with no difference in mortality between surgery performed on weekdays (17% [150 of 889]) and on weekends (20% [54 of 270], p = 0.45), or during nighttime (19% [87 of 467]) versus daytime (17% [117 of 680], p = 0.54). Time from symptoms to surgery (median 7.0 hours vs 6.5 hours, p = 0.31) did not differ between patients who survived and those who died at 30 days. Multivariable regression analysis of risk factors for 30-day mortality showed no weekend effect (odds ratio, 1.04; 95% confidence interval, 60.67 to 1.60; p = 0.875), but nighttime surgery was a risk factor (odds ratio, 2.43; 95% confidence interval, 1.29 to 4.56; p = 0.006).Conclusions: The 30-day mortality in surgical repair of aortic dissection type A was not significantly affected by timing of surgery during weekends versus weekdays. Nighttime surgery seems to predict increased 30-day mortality, after correction for other risk factors.
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Wickbom, Anders,1987-Örebro universitet,Institutionen för medicinska vetenskaper,Department of Cardiothoracic and Vascular Surgery(Swepub:oru)aswm
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Geirsson, ArnarDepartment of Cardiothoracic Surgery, Landspitali University Hospital and Faculty of Medicine, University of Iceland, Reykjavik, Iceland
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Franco-Cereceda, AndersDepartment of Thoracic and Cardiovascular Surgery, Karolinska University Hospital, Stockholm, Sweden
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Ahmad, KhalilDepartment of Thoracic and Cardiovascular Surgery, Aarhus University Hospital, Skejby, Denmark
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Gunn, JarmoHeart Center, Turku University Hospital and University of Turku, Turku, Finland
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Hansson, Emma C.,1985Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:gu)xhanem
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Hjortdal, VibekeDepartment of Thoracic and Cardiovascular Surgery, Aarhus University Hospital, Skejby, Denmark
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Jarvela, KatiDepartment of Thoracic and Cardiovascular Surgery, Aarhus University Hospital, Skejby, Denmark
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Jeppsson, Anders,1960Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:gu)xjepan
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Mennander, AriDepartment of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Nozohoor, ShahabDepartment of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Pan, EmilyHeart Center, Turku University Hospital and University of Turku, Turku, Finland
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Zindovic, IgorDepartment of Clinical Sciences, Skane University Hospital, Lund University, Lund, Sweden; Department of Cardiothoracic Surgery, Skane University Hospital, Lund University, Lund, Sweden
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Gudbjartsson, TomasDepartment of Cardiothoracic Surgery, Landspitali University Hospital and Faculty of Medicine, University of Iceland, Reykjavik, Iceland
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Olsson, ChristianKarolinska Institutet
(author)
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Karolinska InstitutetInstitutionen för medicinska vetenskaper
(creator_code:org_t)
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In:Annals of Thoracic Surgery: Elsevier108:3, s. 770-7760003-49751552-6259
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Ahlsson, Anders
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Wickbom, Anders, ...
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Geirsson, Arnar
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Franco-Cereceda, ...
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Ahmad, Khalil
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Gunn, Jarmo
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Hansson, Emma C. ...
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Hjortdal, Vibeke
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Jarvela, Kati
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Jeppsson, Anders ...
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Mennander, Ari
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Nozohoor, Shahab
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Pan, Emily
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Zindovic, Igor
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Örebro University
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Karolinska Institutet
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University of Gothenburg