AI Article Synopsis
- The study examined the impact of emergency surgery timing on patient outcomes for acute type A aortic dissection (ATAAD) by comparing surgeries performed during working hours and after hours, using data from 2004 to 2019.
- Results showed that the in-hospital mortality rate was 6.9% during working hours and 13.8% after hours, but no significant differences in outcomes, complications, or long-term survival rates were found between the two groups.
- The findings suggest that after-hours surgery did not negatively affect patient outcomes, supporting the need for immediate surgical intervention, and highlight the importance of improving consistency in care during different time periods.
Article Abstract
Purpose: To establish whether emergency surgery performed outside working hours (after hours) contributed to adverse outcomes for patients with acute type A aortic dissection (ATAAD).
Methods: We reviewed the operation records of ATAAD repair in our institution from 2004 to 2019 (n = 187). Emergency surgery was performed by one of a few teams of experienced surgeons, regardless of the time of day. Patients were divided into two groups based on the surgery start time: during working hours (n = 65) and after hours (n = 122). A propensity score-matched analysis was performed for 58 pairs of patients.
Results: The overall in-hospital mortality was 6.9% for the working-hours group and 13.8% for the after-hours group. There were no significant differences between the groups in the relatively limited study population (n = 187). Surgeon experience and aortic interventions did not differ remarkably between the groups. After-hours repair was not associated with postoperative complications. There were no significant differences in the long-term survival or aortic event-free rates between the groups.
Conclusions: After-hours surgery did not affect the short- or long-term outcomes of ATAAD repair under our backup system, which supports the recommendation of immediate surgical repair. Efforts to minimize the discrepancies between working hours and after hours could help to improve the surgical outcomes of patients undergoing ATAAD repair.
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| http://dx.doi.org/10.1007/s00595-022-02487-7 | DOI Listing |
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