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.

Association between night-time surgery and occurrence of intraoperative adverse events and postoperative pulmonary complications / 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, A. Aun, A. Sormus, K. Sarapuu, M. Mall, J. Karjagin, E. Futier, A. Petit, A. Gerard, E. Marret, M. Solier, S. Jaber, A. Prades, J. Krassler, S. Merzky, M.G.D. Abreu, C. Uhlig, T. Kiss, A. Bundy, T. Bluth, A. Gueldner, P. Spieth, M. Scharffenberg, D.T. Thiem, T. Koch, T. Treschan, M. Schaefer, B. Bastin, J. Geib, M. Weiss, P. Kienbaum, B. Pannen, A. Gottschalk, M. Konrad, D. Westerheide, B. Schwerdtfeger, P. Simon, A. Reske, C. Nestler, D. Valsamidis, K. Stroumpoulis, G. Antholopoulos, A. Andreou, D. Karapanos, K. Theodorak, G. Gkiokas, M.K. Tasoulis, T. Sidiropoulou, F. Zafeiropoulou, P. Florou, A. Pandazi, G. Tsaousi, C. Nouris, C. Pourzitaki, D. Bystritski, R. Pizov, A. Eden, C.V. Pesce, A. Campanile, A. Marrella, S. Grasso, M.D. Michele, F. Bona, G. Giacoletto, E. Sardo, L.G.V. Sottosanti, M. Solca, C.A. Volta, S. Spadaro, M. Verri, R. Ragazzi, R. Zoppellari, G. Cinnella, P. Raimondo, D.L. Bella, L. Mirabella, D. D'Antini, A. Molin, I. Brunetti, A. Gratarola, G. Pellerano, R. Sileo, S. Pezzatto, L. Montagnani, L. Pasin, G. Landoni, A. Zangrillo, L. Beretta, A.L.D. Parma, V. Tarzia, R. Dossi, M.E. Sassone, D. Sances, S. Tredici, G. Spano, G. Castellani, L. Delunas, S. Peradze, M. Venturino, I. Arpino, S. Sher, C. Tommasino, F. Rapido, P. Morelli, M. Vargas, G. Servillo, S.M. Raineri, F. Montalto, V. Russotto, A. Giarratano, M. Baciarello, M. Generali, G. Cerati, Y. Leykin, F. Bressan, V. Bartolini, L. Zamidei, L. Brazzi, C. Liperi, G. Sales, L. Pistidda, E. Brugnoni, G. Musella, A. Bacuzzi, D. Muhardri, G.G. Agreta, F. Sada, A. Bytyqi, A. Karbonskiene, R. Aukstakalniene, Z. Teberaite, E. Salciute, R. Tikuisis, P. Miliauskas, S. Jurate, E. Kontrimaviciute, G. Tomkute, J. Xuereb, M. Bezzina, F.J. Borg, S. Hemmes, M. Schultz, M. Hollmann, I. Wiersma, J. Binnekade, L. Bos, C. Boer, A. Duvekot, B.I.'. Veld, A. Werger, P. Dennesen, C. Severijns, J.D. Jong, J. Hering, R.V. Beek, S. Ivars, I.B. Jammer, A. Breidablik, K.S. Hodt, F. Fjellanger, M.V. Avalos, M.O. Jannicke, E. Andersson, S.K. Amir, R. Molina, S. Wutai, E. Morais, G. Tareco, D. Ferreira, J. Amaral, M.D.L.G. Castro, S. Cadilha, S. Appleton, S. Parente, M. Correia, D. Martins, A. Monteirosa, A. Ricardo, S. Rodrigues, L. Horhota, I.M. Grintescu, L. Mirea, I.C. Grintescu, D. Corneci, S. Negoita, M. Dutu, I. Popescu Garotescu, D. Filipescu, A.B. Prodan, G. Droc, R. Fota, M. Popescu, D. Tomescu, A.M. Petcu, M.I. Tudoroiu, A. Moise, C.T. Guran, I. Gherghina, D. Costea, I. Cindea, S.M. Copotoiu, R. Copotoiu, V. Barsan, Z. Tolcser, M. Riciu, S.G. Moldovan, M. Veres, A. Gritsan, T. Kapkan, G. Gritsan, O. Korolkov, A. Kulikov, A. Lubnin, A. Ovezov, P. Prokoshev, A. Lugovoy, N. Anipchenko, A. Babayants, I. Komissarova, K. Zalina, V. Likhvantsev, S. Fedorov, A. Lazukic, J. Pejakovic, D. Mihajlovic, Z. Kusnierikova, M. Zelinkova, K. Bruncakova, L. Polakovicova, V. Sobona, N.S. Barbka, P.G. Ana, M. Jovanov, B. Strazisar, M.B. Jasmina, N.J. Vesna, M. Voje, A. Grynyuk, I. Kostadinov, S.V. Alenka, V. Moral, M.C. Unzueta, C. Puigbo, J. Fava, E. Moret, M.R. Nunez, M. Sendra, A. Brunelli, F. Rodenas, P. Monedero, F.H. Martinez, M.J.Y. Temino, A.M. Simon, A.D.A. Larriba, A. Lisi, G. Perez, R. Martinez, M. Granell, J.T. Vivo, C.S. Ruiz, J.A.D. Andres Ibanez, E. Pastor, M. Soro, C. Ferrando, M. Defez, A.S. Cesar Aldecoa, R. Perez, J. Rico, M. Jawad, Y. Saeed, L. Gillberg, Z.K. Bengisun, B.K. Kazbek, N. Coskunfirat, N. Boztug, S. Sanli, M. Yilmaz, N. Hadimioglu, N.M. Senturk, E. Camci, S. Kucukgoncu, Z. Sungur, N. Sivrikoz, S.U. Ozgen, F. Toraman, O. Selvi, O. Senturk, M. Yildiz, B. Kuvaki, F. Gunenc, S. Kucukguclu, S. Ozbilgin, J. Maral, S. Canli, O. Arun, A. Saltali, E. Aydogan, F.N. Akgun, C. Sanlikarip, F.M. Karaman, A. Mazur, S. Vorotyntsev, G. Rousseau, C. Barrett, L. Stancombe, B. Shelley, H. Scholes, J. Limb, A. Rafi, L. Wayman, J. Deane, D. Rogerson, J. Williams, S. Yates, E. Rogers, M. Pulletz, S. Moreton, S. Jones, S. Venkatesh, M. Burton, L. Brown, C. Goodall, M. Rucklidge, D. Fuller, M. Nadolski, S. Kusre, M. Lundberg, L. Everett, H. Nutt, M. Zuleika, P. Carvalho, D. Clements, C.B. Ben, P. Watt, P. Raymode, R. Pearse, O. Mohr, A. Raj, T. Creary, A. Chishti, A. Bell, C. Higham, A. Cain, S. Gibb, S. Mowat, D. Franklin, C. West, G. Minto, N. Boyd, G. Mills, E. Calton, R. Walker, F. Mackenzie, B. Ellison, H. Roberts, M. Chikungwa, C. Jackson, A. Donovan, J. Foot, E. Homan, J. Montgomery, D. Portch, P. Mercer, J. Palmer, J. Paddle, A. Fouracres, A. Datson, A. Andrew, L. Welch, A. Rose, S. Varma, K. Simeson, M. Rambhatla, J. Susarla, S. Marri, K. Kodaganallur, A. Das, S. Algarsamy, J. Colley, S. Davies, M. Szewczyk, T. Smith, F.B. Ana, E. Luzier, A. Almagro, M.V. Melo, L. Fernando, D. Sulemanji, J. Sprung, T. Weingarten, D. Kor, F. Scavonetto, Y. Tze. - In: BRITISH JOURNAL OF ANAESTHESIA. - ISSN 0007-0912. - 122:3(2019), pp. 361-369.

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

Tommasino C.;Rapido F.;Morelli P.;Brazzi L.;
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.
general anaesthesia; intraoperative complications; patient safety; postoperative complications; pulmonary; Adult; After-Hours Care; Aged; Cohort Studies; Female; Humans; Incidence; Internationality; Intraoperative Complications; Lung Diseases; Male; Middle Aged; Postoperative Complications; Prospective Studies; Risk Factors; Surgical Procedures, Operative
Settore MED/41 - Anestesiologia
BRITISH JOURNAL OF ANAESTHESIA
Article (author)
File in questo prodotto:
File Dimensione Formato  
2019 Br J Anaesth Night time surgery.pdf

non disponibili

Tipologia: Publisher's version/PDF
Dimensione 334.66 kB
Formato Adobe PDF
334.66 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

Caricamento pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/670395
Citazioni
  • ???jsp.display-item.citation.pmc??? 9
  • Scopus 18
  • ???jsp.display-item.citation.isi??? 17
social impact