Publication details

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

Authors	CORTEGIANI A GREGORETTI C NETO AS HEMMES SNT BALL L CANET J HIESMAYR M HOLLMANN MW MILLS GH MELO MFV PUTENSEN C SCHMID W SEVERGNINI P WRIGGE H DE Abreu MG SCHULTZ MJ PELOSI P KROELL W METZLER H STRUBER G WEGSCHEIDER T GOMBOTZ H HIESMAYR M SCHMID W URBANEK B KAHN D MOMENI M POSPIECH A LOIS F FORGET P GROSU I POELAERT J VAN Mossevelde V VAN Malderen MC DYLST D VAN Melkebeek J BERAN M DE Hert S DE Baerdemaeker L HEYSE B VAN Limmen J WYFFELS P JACOBS T ROELS N DE Bruyne A VAN de Velde S LEVA B DAMSTER S PLICHON B JUROS-ZOVKO M DJONOVIC-OMANOVIC D PERNAR S ZUNIC J MISKOVIC P ZILIC A KVOLIK S IVIC D AZENIC-VENZERA D SKILJIC S VINKOVIC H OPUTRIC I JURICIC K FRKOVIC V KOPIC J MIRKOVIC I KARANOVIC N CAREV M DROPULIC N SARIC JP ERCEG G DVORSCAK MB MAZUL-SUNKO B PAVICIC AM GORANOVIC T MALDINI B RADOCAJ T GAVRANOVIC Z MLADIC-BATINICA I SEHOVIC M ŠTOURAČ Petr HARAZIM Hana SMÉKALOVÁ Olga KOSINOVÁ Martina KOLACEK T HUDÁČEK Kamil DRAB M BRUJEVIC J VITKOVA K JIRMANOVA K VOLFOVA I DZURNAKOVA P LISKOVA K DUDAS R FILIPSKY R EL Kafrawy S ABDELWAHAB HH METWALLY T ABDEL-RAZEK A EL-SHAARAWY AM HASAN WF AHMED AG 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 UHLIG C KISS T BUNDY A BLUTH T GUELDNER A SPIETH P SCHARFFENBERG M THIEM DT KOCH T TRESCHAN T SCHAEFER M BASTIN B GEIB J WEISS M KIENBAUM P PANNEN B GOTTSCHALK A KONRAD M WESTERHEIDE D SCHWERDTFEGER B WRIGGE H SIMON P RESKE A NESTLER C VALSAMIDIS D STROUMPOULIS K ANTHOLOPOULOS G ANDREOU A KARAPANOS D THEODORAK K GKIOKAS G TASOULIS MK SIDIROPOULOU T ZAFEIROPOULOU F FLOROU P PANDAZI A TSAOUSI G NOURIS C POURZITAKI C BYSTRITSKI D PIZOV R EDEN A PESCE CV CAMPANILE A MARRELLA A GRASSO S DE Michele M BONA F GIACOLETTO G SARDO E SOTTOSANTI LGV SOLCA M VOLTA CA SPADARO S VERRI M RAGAZZI R ZOPPELLARI R CINNELLA G RAIMONDO P LA Bella D MIRABELLA L D D antini MOLIN A BRUNETTI I GRATAROLA A PELLERANO G SILEO R PEZZATTO S MONTAGNANI L PASIN L LANDONI G ZANGRILLO A BERETTA L DI Parma AL TARZIA V DOSSI R SASSONE ME 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 SM 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 SEVERGNINI P BRUGNONI E MUSELLA G BACUZZI A MUHARDRI D GECAJ-GASHI A 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 FJ HEMMES S SCHULTZ M HOLLMANN M WIERSMA I BINNEKADE J BOS L BOER C DUVEKOT A IN t Veld B WERGER A DENNESEN P SEVERIJNS C DE Jong J HERING J VAN Beek R IVARS S JAMMER I BREIDABLIK A HODT KS FJELLANGER F AVALOS MV MELLIN-OLSEN J ANDERSSON E SHAFI-KABIRI A MOLINA R WUTAI S MORAIS E TARECO G FERREIRA D AMARAL J CASTRO MDG CADILHA S APPLETON S PARENTE S CORREIA M MARTINS D MONTEIROSA A RICARDO A RODRIGUES S HORHOTA L GRINTESCU IM MIREA L GRINTESCU IC CORNECI D NEGOITA S DUTU M GAROTESCU IP FILIPESCU D PRODAN AB DROC G FOTA R POPESCU M TOMESCU D PETCU AM TUDOROIU MI MOISE A GURAN CT GHERGHINA I COSTEA D CINDEA I COPOTOIU SM COPOTOIU R BARSAN V TOLCSER Z RICIU M MOLDOVAN SG 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 NOVAK-SUPE B PEKLE-GOLEZ A JOVANOV M STRAZISAR B MARKOVIC-BOZIC J NOVAK-JANKOVIC V VOJE M GRYNYUK A KOSTADINOV I SPINDLER-VESEL A MORAL V UNZUETA MC PUIGBO C FAVA J MORET E NUNEZ MR SENDRA M BRUNELLI A RODENAS F MONEDERO P MARTINEZ FH TEMINO MJY AM Simon LARRIBA AD LISI A PEREZ G MARTINEZ R GRANELL M VIVO JT RUIZ CS IBANEZ JAD PASTOR E SORO M FERRANDO C DEFEZ M ALVARES-SANTULLANO CA PEREZ R RICO J JAWAD M SAEED Y GILLBERG L BENGISUN ZK KAZBEK BK COSKUNFIRAT N BOZTUG N SANLI S YILMAZ M HADIMIOGLU N SENTURK NM CAMCI E KUCUKGONCU S SUNGUR Z SIVRIKOZ N OZGEN SU 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 FN SANLIKARIP C KARAMAN FM 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 CREAGH-BROWN 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 FERNANDEZ-BUSTAMANTE A LUZIER E ALMAGRO A MELO MV FERNANDO L SULEMANJI D SPRUNG J WEINGARTEN T KOR D SCAVONETTO F TZE Y
Year of publication	2019
Type	Article in Periodical
Magazine / Source	British Journal of Anaesthesia
MU Faculty or unit	Faculty of Medicine
Citation
Doi	http://dx.doi.org/10.1016/j.bja.2018.10.063
Keywords	general anaesthesia; intraoperative complications; patient safety; postoperative complications; pulmonary
Description	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.