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Association between night-time surgery and occurrence of intraoperative adverse events and postoperative pulmonary complications

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2019-03-01
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14716771
00070912
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10.1016/j.bja.2018.10.063
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2-s2.0-85058784675
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Mahidol University
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British Journal of Anaesthesia. Vol.122, No.3 (2019), 361-369
Citation
A. Cortegiani, C. Gregoretti, A. S. Neto, S. N.T. Hemmes, L. Ball, J. Canet, M. Hiesmayr, M. W. Hollmann, G. H. Mills, M. F.V. Melo, C. Putensen, W. Schmid, P. Severgnini, H. Wrigge, M. Gama de Abreu, M. J. Schultz, P. Pelosi, W. Kroell, H. Metzler, G. Struber, T. Wegscheider, H. Gombotz, B. Urbanek, D. Kahn, M. Momeni, A. Pospiech, F. Lois, P. Forget, I. Grosu, J. Poelaert, V. Mossevelde, M. C. van Malderen, D. Dylst, J. V. Melkebeek, M. Beran, S. D. Hert, L. D. Baerdemaeker, B. Heyse, J. V. Limmen, P. Wyffels, T. Jacobs, N. Roels, A. D. Bruyne, S. V.D. Velde, J. Z. Marina, D. O. Dejana, S. Pernar, J. Zunic, P. Miskovic, A. Zilic, S. Kvolik, D. Ivic, A. V. Darija, S. Skiljic, H. Vinkovic, I. Oputric, K. Juricic, V. Frkovic, J. Kopic, I. Mirkovic, J. P. Saric, G. Erceg, M. B. Dvorscak, M. S. Branka, A. M. Pavicic, T. Goranovic, B. Maldini, T. Radocaj, Z. Gavranovic, M. B. Inga, M. Sehovic, P. Stourac, H. Harazim, O. Smekalova, M. Kosinova, T. Kolacek, K. Hudacek, M. Drab, J. Brujevic, K. Vitkova, K. Jirmanova, I. Volfova, P. Dzurnakova, K. Liskova, R. Dudas, R. Filipsky, S. E. Kafrawy, H. H. Abdelwahab, T. Metwally, A. R. Ahmed, E. S. Ahmed Mostafa, W. F. Hasan, A. G. Ahmed, H. Yassin, M. Magdy, M. Abdelhady, M. Mahran, E. Herodes, P. Kivik, J. Oganjan (2019). Association between night-time surgery and occurrence of intraoperative adverse events and postoperative pulmonary complications. Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/51853.
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Association between night-time surgery and occurrence of intraoperative adverse events and postoperative pulmonary complications
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Author(s)
A. Cortegiani
 C. Gregoretti
 A. S. Neto
 S. N.T. Hemmes
 L. Ball
 J. Canet
 M. Hiesmayr
 M. W. Hollmann
 G. H. Mills
 M. F.V. Melo
 C. Putensen
 W. Schmid
 P. Severgnini
 H. Wrigge
 M. Gama de Abreu
 M. J. Schultz
 P. Pelosi
 W. Kroell
 H. Metzler
 G. Struber
 T. Wegscheider
 H. Gombotz
 B. Urbanek
 D. Kahn
 M. Momeni
 A. Pospiech
 F. Lois
 P. Forget
 I. Grosu
 J. Poelaert
 V. Mossevelde
 M. C. van Malderen
 D. Dylst
 J. V. Melkebeek
 M. Beran
 S. D. Hert
 L. D. Baerdemaeker
 B. Heyse
 J. V. Limmen
 P. Wyffels
 T. Jacobs
 N. Roels
 A. D. Bruyne
 S. V.D. Velde
 J. Z. Marina
 D. O. Dejana
 S. Pernar
 J. Zunic
 P. Miskovic
 A. Zilic
 S. Kvolik
 D. Ivic
 A. V. Darija
 S. Skiljic
 H. Vinkovic
 I. Oputric
 K. Juricic
 V. Frkovic
 J. Kopic
 I. Mirkovic
 J. P. Saric
 G. Erceg
 M. B. Dvorscak
 M. S. Branka
 A. M. Pavicic
 T. Goranovic
 B. Maldini
 T. Radocaj
 Z. Gavranovic
 M. B. Inga
 M. Sehovic
 P. Stourac
 H. Harazim
 O. Smekalova
 M. Kosinova
 T. Kolacek
 K. Hudacek
 M. Drab
 J. Brujevic
 K. Vitkova
 K. Jirmanova
 I. Volfova
 P. Dzurnakova
 K. Liskova
 R. Dudas
 R. Filipsky
 S. E. Kafrawy
 H. H. Abdelwahab
 T. Metwally
 A. R. Ahmed
 E. S. Ahmed Mostafa
 W. F. Hasan
 A. G. Ahmed
 H. Yassin
 M. Magdy
 M. Abdelhady
 M. Mahran
 E. Herodes
 P. Kivik
 J. Oganjan
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Ospedale Policlinico San Martino
 KBC Osijek
 Klinički Bolnički Centar
 Universitair Ziekenhuis Brussel
 General Hospital Karlovac
 Dr. Josip Bencevic General Hospital
 University Hospital in Ostrava
 Ziekenhuis Oost-Limburg
 University Hospital of Ghent
 Universitäts-Klinikum Bonn und Medizinische Fakultät
 Massachusetts General Hospital
 Hospital Universitari Germans Trias i Pujol
 Fayoum University
 Dresden University Faculty of Medicine and University Hospital Carl Gustav Carus
 Università degli Studi di Genova
 Fakultni Nemocnice Brno
 Faculty Hospital at Hradec Kralove
 Università degli Studi di Palermo
 Hospital Israelita Albert Einstein
 Cliniques Universitaires Saint-Luc
 Mahidol University
 Medizinische Universitat Wien
 Cairo University
 Universität Leipzig
 University of Zagreb School of Medicine
 Università degli Studi dell'Insubria
 LKH-Universitätsklinikum Graz
 Universiteit van Amsterdam
 University of Sheffield
 Suis medical Insurance Hospital
 Laboratorio Centralizzato Policlinico "P.Giaccone"
 Beni Sueif University Hospital
 North Estonia Medical Center
 AZ Maria Middelares
 Nemocnice Znojmo
 AKH Linz
 General Hospital Čakovec
 El Sahel Teaching Hospital
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Abstract
© 2018 British Journal of Anaesthesia 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.
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https://repository.li.mahidol.ac.th/handle/123456789/51853
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Scopus 2019