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Background: The aim of this post hoc analysis of a large cohort study was to evaluate the association between night-time surgery and the occurrence of intraoperative adverse events (AEs) and postoperative pulmonary complications (PPCs). Methods: LAS VEGAS (Local Assessment of Ventilatory Management During General Anesthesia for Surgery) was a prospective international 1-week study that enrolled adult patients undergoing surgical procedures with general anaesthesia and mechanical ventilation in 146 hospitals across 29 countries. Surgeries were defined as occurring during ‘daytime’ when induction of anaesthesia was between 8:00 AM and 7:59 PM, and as ‘night-time’ when induction was between 8:00 PM and 7:59 AM. Results: Of 9861 included patients, 555 (5.6%) underwent surgery during night-time. The proportion of patients who developed intraoperative AEs was higher during night-time surgery in unmatched (43.6% vs 34.1%; P<0.001) and propensity-matched analyses (43.7% vs 36.8%; P=0.029). PPCs also occurred more often in patients who underwent night-time surgery (14% vs 10%; P=0.004) in an unmatched cohort analysis, although not in a propensity-matched analysis (13.8% vs 11.8%; P=0.39). In a multivariable regression model, including patient characteristics and types of surgery and anaesthesia, night-time surgery was independently associated with a higher incidence of intraoperative AEs (odds ratio: 1.44; 95% confidence interval: 1.09–1.90; P=0.01), but not with a higher incidence of PPCs (odds ratio: 1.32; 95% confidence interval: 0.89–1.90; P=0.15). Conclusions: Intraoperative adverse events and postoperative pulmonary complications occurred more often in patients undergoing night-time surgery. Imbalances in patients’ clinical characteristics, types of surgery, and intraoperative management at night-time partially explained the higher incidence of postoperative pulmonary complications, but not the higher incidence of adverse events. Clinical trial registration: NCT01601223.
Cortegiani, A., Gregoretti, C., Neto, A., Hemmes, S., Ball, L., Canet, J., et al. (2019). Association between night-time surgery and occurrence of intraoperative adverse events and postoperative pulmonary complications. BRITISH JOURNAL OF ANAESTHESIA, 122(3), 361-369 [10.1016/j.bja.2018.10.063].
Association between night-time surgery and occurrence of intraoperative adverse events and postoperative pulmonary complications
Cortegiani A.
;Gregoretti C.;Neto A. S.;Hemmes S. N. T.;Ball L.;Canet J.;Hiesmayr M.;Hollmann M. W.;Mills G. H.;Melo M. F. V.;Putensen C.;Schmid W.;Severgnini P.;Wrigge H.;Gama de Abreu M.;Schultz M. J.;Pelosi P.;Kroell W.;Metzler H.;Struber G.;Wegscheider T.;Gombotz H.;Urbanek B.;Kahn D.;Momeni M.;Pospiech A.;Lois F.;Forget P.;Grosu I.;Poelaert J.;Mossevelde V.;van Malderen M. C.;Dylst D.;Melkebeek J. V.;Beran M.;Hert S. D.;Baerdemaeker L. D.;Heyse B.;Limmen J. V.;Wyffels P.;Jacobs T.;Roels N.;Bruyne A. D.;Velde S. V. D.;Marina J. Z.;Dejana D. O.;Pernar S.;Zunic J.;Miskovic P.;Zilic A.;Kvolik S.;Ivic D.;Darija A. V.;Skiljic S.;Vinkovic H.;Oputric I.;Juricic K.;Frkovic V.;Kopic J.;Mirkovic I.;Saric J. P.;Erceg G.;Dvorscak M. B.;Branka M. S.;Pavicic A. M.;Goranovic T.;Maldini B.;Radocaj T.;Gavranovic Z.;Inga M. B.;Sehovic M.;Stourac P.;Harazim H.;Smekalova O.;Kosinova M.;Kolacek T.;Hudacek K.;Drab M.;Brujevic J.;Vitkova K.;Jirmanova K.;Volfova I.;Dzurnakova P.;Liskova K.;Dudas R.;Filipsky R.;Kafrawy S. E.;Abdelwahab H. H.;Metwally T.;Ahmed A. R.;Ahmed Mostafa E. S.;Hasan W. F.;Ahmed A. G.;Yassin H.;Magdy M.;Abdelhady M.;Mahran M.;Herodes E.;Kivik P.;Oganjan J.;Aun A.;Sormus A.;Sarapuu K.;Mall M.;Karjagin J.;Futier E.;Petit A.;Gerard A.;Marret E.;Solier M.;Jaber S.;Prades A.;Krassler J.;Merzky S.;Abreu M. G. D.;Uhlig C.;Kiss T.;Bundy A.;Bluth T.;Gueldner A.;Spieth P.;Scharffenberg M.;Thiem D. T.;Koch T.;Treschan T.;Schaefer M.;Bastin B.;Geib J.;Weiss M.;Kienbaum P.;Pannen B.;Gottschalk A.;Konrad M.;Westerheide D.;Schwerdtfeger B.;Simon P.;Reske A.;Nestler C.;Valsamidis D.;Stroumpoulis K.;Antholopoulos G.;Andreou A.;Karapanos D.;Theodorak K.;Gkiokas G.;Tasoulis M. K.;Sidiropoulou T.;Zafeiropoulou F.;Florou P.;Pandazi A.;Tsaousi G.;Nouris C.;Pourzitaki C.;Bystritski D.;Pizov R.;Eden A.;Pesce C. V.;Campanile A.;Marrella A.;Grasso S.;Michele M. D.;Bona F.;Giacoletto G.;Sardo E.;Sottosanti L. G. V.;Solca M.;Volta C. A.;Spadaro S.;Verri M.;Ragazzi R.;Zoppellari R.;Cinnella G.;Raimondo P.;Bella D. L.;Mirabella L.;D'antini D.;Molin A.;Brunetti I.;Gratarola A.;Pellerano G.;Sileo R.;Pezzatto S.;Montagnani L.;Pasin L.;Landoni G.;Zangrillo A.;Beretta L.;Parma A. L. D.;Tarzia V.;Dossi R.;Sassone M. E.;Sances D.;Tredici S.;Spano G.;Castellani G.;Delunas L.;Peradze S.;Venturino M.;Arpino I.;Sher S.;Tommasino C.;Rapido F.;Morelli P.;Vargas M.;Servillo G.;Raineri S. M.;Montalto F.;Russotto V.;Giarratano A.;Baciarello M.;Generali M.;Cerati G.;Leykin Y.;Bressan F.;Bartolini V.;Zamidei L.;Brazzi L.;Liperi C.;Sales G.;Pistidda L.;Brugnoni E.;Musella G.;Bacuzzi A.;Muhardri D.;Agreta G. G.;Sada F.;Bytyqi A.;Karbonskiene A.;Aukstakalniene R.;Teberaite Z.;Salciute E.;Tikuisis R.;Miliauskas P.;Jurate S.;Kontrimaviciute E.;Tomkute G.;Xuereb J.;Bezzina M.;Borg F. J.;Hemmes S.;Schultz M.;Hollmann M.;Wiersma I.;Binnekade J.;Bos L.;Boer C.;Duvekot A.;Veld B. I. '.;Werger A.;Dennesen P.;Severijns C.;Jong J. D.;Hering J.;Beek R. V.;Ivars S.;Jammer I. B.;Breidablik A.;Hodt K. S.;Fjellanger F.;Avalos M. V.;Jannicke M. O.;Andersson E.;Amir S. K.;Molina R.;Wutai S.;Morais E.;Tareco G.;Ferreira D.;Amaral J.;Castro M. D. L. G.;Cadilha S.;Appleton S.;Parente S.;Correia M.;Martins D.;Monteirosa A.;Ricardo A.;Rodrigues S.;Horhota L.;Grintescu I. M.;Mirea L.;Grintescu I. C.;Corneci D.;Negoita S.;Dutu M.;Popescu Garotescu I.;Filipescu D.;Prodan A. B.;Droc G.;Fota R.;Popescu M.;Tomescu D.;Petcu A. M.;Tudoroiu M. I.;Moise A.;Guran C. T.;Gherghina I.;Costea D.;Cindea I.;Copotoiu S. M.;Copotoiu R.;Barsan V.;Tolcser Z.;Riciu M.;Moldovan S. G.;Veres M.;Gritsan A.;Kapkan T.;Gritsan G.;Korolkov O.;Kulikov A.;Lubnin A.;Ovezov A.;Prokoshev P.;Lugovoy A.;Anipchenko N.;Babayants A.;Komissarova I.;Zalina K.;Likhvantsev V.;Fedorov S.;Lazukic A.;Pejakovic J.;Mihajlovic D.;Kusnierikova Z.;Zelinkova M.;Bruncakova K.;Polakovicova L.;Sobona V.;Barbka N. S.;Ana P. G.;Jovanov M.;Strazisar B.;Jasmina M. B.;Vesna N. J.;Voje M.;Grynyuk A.;Kostadinov I.;Alenka S. V.;Moral V.;Unzueta M. C.;Puigbo C.;Fava J.;Moret E.;Nunez M. R.;Sendra M.;Brunelli A.;Rodenas F.;Monedero P.;Martinez F. H.;Temino M. J. Y.;Simon A. M.;Larriba A. D. A.;Lisi A.;Perez G.;Martinez R.;Granell M.;Vivo J. T.;Ruiz C. S.;Andres Ibanez J. A. D.;Pastor E.;Soro M.;Ferrando C.;Defez M.;Cesar Aldecoa A. S.;Perez R.;Rico J.;Jawad M.;Saeed Y.;Gillberg L.;Bengisun Z. K.;Kazbek B. K.;Coskunfirat N.;Boztug N.;Sanli S.;Yilmaz M.;Hadimioglu N.;Senturk N. M.;Camci E.;Kucukgoncu S.;Sungur Z.;Sivrikoz N.;Ozgen S. U.;Toraman F.;Selvi O.;Senturk O.;Yildiz M.;Kuvaki B.;Gunenc F.;Kucukguclu S.;Ozbilgin S.;Maral J.;Canli S.;Arun O.;Saltali A.;Aydogan E.;Akgun F. N.;Sanlikarip C.;Karaman F. M.;Mazur A.;Vorotyntsev S.;Rousseau G.;Barrett C.;Stancombe L.;Shelley B.;Scholes H.;Limb J.;Rafi A.;Wayman L.;Deane J.;Rogerson D.;Williams J.;Yates S.;Rogers E.;Pulletz M.;Moreton S.;Jones S.;Venkatesh S.;Burton M.;Brown L.;Goodall C.;Rucklidge M.;Fuller D.;Nadolski M.;Kusre S.;Lundberg M.;Everett L.;Nutt H.;Zuleika M.;Carvalho P.;Clements D.;Ben C. B.;Watt P.;Raymode P.;Pearse R.;Mohr O.;Raj A.;Creary T.;Chishti A.;Bell A.;Higham C.;Cain A.;Gibb S.;Mowat S.;Franklin D.;West C.;Minto G.;Boyd N.;Mills G.;Calton E.;Walker R.;Mackenzie F.;Ellison B.;Roberts H.;Chikungwa M.;Jackson C.;Donovan A.;Foot J.;Homan E.;Montgomery J.;Portch D.;Mercer P.;Palmer J.;Paddle J.;Fouracres A.;Datson A.;Andrew A.;Welch L.;Rose A.;Varma S.;Simeson K.;Rambhatla M.;Susarla J.;Marri S.;Kodaganallur K.;Das A.;Algarsamy S.;Colley J.;Davies S.;Szewczyk M.;Smith T.;Ana F. B.;Luzier E.;Almagro A.;Melo M. V.;Fernando L.;Sulemanji D.;Sprung J.;Weingarten T.;Kor D.;Scavonetto F.;Tze Y.
2019
Abstract
Background: The aim of this post hoc analysis of a large cohort study was to evaluate the association between night-time surgery and the occurrence of intraoperative adverse events (AEs) and postoperative pulmonary complications (PPCs). Methods: LAS VEGAS (Local Assessment of Ventilatory Management During General Anesthesia for Surgery) was a prospective international 1-week study that enrolled adult patients undergoing surgical procedures with general anaesthesia and mechanical ventilation in 146 hospitals across 29 countries. Surgeries were defined as occurring during ‘daytime’ when induction of anaesthesia was between 8:00 AM and 7:59 PM, and as ‘night-time’ when induction was between 8:00 PM and 7:59 AM. Results: Of 9861 included patients, 555 (5.6%) underwent surgery during night-time. The proportion of patients who developed intraoperative AEs was higher during night-time surgery in unmatched (43.6% vs 34.1%; P<0.001) and propensity-matched analyses (43.7% vs 36.8%; P=0.029). PPCs also occurred more often in patients who underwent night-time surgery (14% vs 10%; P=0.004) in an unmatched cohort analysis, although not in a propensity-matched analysis (13.8% vs 11.8%; P=0.39). In a multivariable regression model, including patient characteristics and types of surgery and anaesthesia, night-time surgery was independently associated with a higher incidence of intraoperative AEs (odds ratio: 1.44; 95% confidence interval: 1.09–1.90; P=0.01), but not with a higher incidence of PPCs (odds ratio: 1.32; 95% confidence interval: 0.89–1.90; P=0.15). Conclusions: Intraoperative adverse events and postoperative pulmonary complications occurred more often in patients undergoing night-time surgery. Imbalances in patients’ clinical characteristics, types of surgery, and intraoperative management at night-time partially explained the higher incidence of postoperative pulmonary complications, but not the higher incidence of adverse events. Clinical trial registration: NCT01601223.
Cortegiani, A., Gregoretti, C., Neto, A., Hemmes, S., Ball, L., Canet, J., et al. (2019). Association between night-time surgery and occurrence of intraoperative adverse events and postoperative pulmonary complications. BRITISH JOURNAL OF ANAESTHESIA, 122(3), 361-369 [10.1016/j.bja.2018.10.063].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/261101
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simulazione ASN
Il report seguente simula gli indicatori relativi alla propria produzione scientifica in relazione alle soglie ASN 2023-2025 del proprio SC/SSD. Si ricorda che il superamento dei valori soglia (almeno 2 su 3) è requisito necessario ma non sufficiente al conseguimento dell'abilitazione. La simulazione si basa sui dati IRIS e sugli indicatori bibliometrici alla data indicata e non tiene conto di eventuali periodi di congedo obbligatorio, che in sede di domanda ASN danno diritto a incrementi percentuali dei valori. La simulazione può differire dall'esito di un’eventuale domanda ASN sia per errori di catalogazione e/o dati mancanti in IRIS, sia per la variabilità dei dati bibliometrici nel tempo. Si consideri che Anvur calcola i valori degli indicatori all'ultima data utile per la presentazione delle domande.
La presente simulazione è stata realizzata sulla base delle specifiche raccolte sul tavolo ER del Focus Group IRIS coordinato dall’Università di Modena e Reggio Emilia e delle regole riportate nel DM 598/2018 e allegata Tabella A. Cineca, l’Università di Modena e Reggio Emilia e il Focus Group IRIS non si assumono alcuna responsabilità in merito all’uso che il diretto interessato o terzi faranno della simulazione. Si specifica inoltre che la simulazione contiene calcoli effettuati con dati e algoritmi di pubblico dominio e deve quindi essere considerata come un mero ausilio al calcolo svolgibile manualmente o con strumenti equivalenti.
