Association between night/after-hours surgery and mortality: a systematic review and meta-analysis

British Journal of Anaesthesia
Andrea CortegianiSharon Einav

Abstract

The association between night/after-hours surgery and patients' mortality is unclear. The protocol of this systematic review was registered in PROSPERO (CRD42019128534). We searched Medline, PubMed, and EMBASE from inception until August 29, 2019 for studies examining an association between timing of surgical procedures (time of anaesthesia induction or surgery start) and mortality (within 30 days or in-hospital) in adult patients. Studies reporting patients' mortality after surgery performed during the weekend only were excluded. All analyses were done using the random-effects model. We included 40 observational studies (36 retrospective and four prospective) that examined a total of 2 957 065 patients. Twenty-eight studies were judged of good quality and 12 of poor quality according to Newcastle-Ottawa score, owing to a lack of adequate comparability between study groups. Primary analysis from adjusted estimates demonstrated as association between night/after-hours surgery and a higher risk of mortality (odds ratio [OR]=1.16; 95% confidence interval [CI], 1.06-1.28; P=0.002; number of studies=18; I2=67%) based on low certainty evidence. Analysis from unadjusted estimates demonstrated a consistent association (OR=1.47; 95% CI,...Continue Reading

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Citations

Oct 19, 2020·Pediatric Transplantation·Michael E RogersFeng-Chang Lin
Oct 22, 2020·International Journal of Environmental Research and Public Health·Łukasz WarchałowskiRobert Podlasek
May 14, 2021·Journal of Cardiothoracic and Vascular Anesthesia·Kai QiuAdam A Dalia
Jul 12, 2021·Irish Journal of Medical Science·Enda Hannan, Sherif El-Masry

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