Surgery Start Time Does Not Impact Outcome in Elective Cardiac Surgery

Area of Science:

• Cardiovascular Surgery
• Anesthesiology
• Health Services Research

Background:

• Timing of elective cardiac surgery is a critical factor in operating room scheduling and resource allocation.
• Previous research has not conclusively determined if late-night surgery start times affect patient outcomes.

Purpose of the Study:

• To investigate the association between elective cardiac surgery start times and patient outcomes.
• To analyze the impact of surgery timing on morbidity, mortality, and hospital length of stay.

Main Methods:

• Retrospective study design utilizing data from a single academic institution.
• Inclusion of patients undergoing elective cardiac surgery over a 3-year period.
• Comparison of outcomes between patients with anesthesia start times during daytime hours versus nighttime hours, using propensity-score matching.

Main Results:

• No statistically significant differences in mortality, individual or composite morbidity were observed based on surgery start time.
• Hospital length of stay metrics did not significantly differ between daytime and nighttime surgery groups.
• Propensity-score matching confirmed the lack of association between surgery timing and adverse outcomes.

Conclusions:

• Elective cardiac surgery can be safely performed during late-night hours without negatively impacting patient outcomes.
• Institutional support, including 24-hour intensivist coverage, may be crucial for successful late-night procedures and fast-track extubation.
• Findings suggest potential for increased operating room efficiency through flexible scheduling of elective cardiac surgeries.