Surgery Start Time Does Not Impact Outcome in Elective Cardiac Surgery

Abstract

Determine if surgery start time impacts patient outcomes in elective cardiac surgery. This was a retrospective study. This study was based at a single academic institution. Patients undergoing elective cardiac surgery over a 3-year period were included. There were no interventions. The authors performed a retrospective study of patients undergoing elective cardiac surgery over a 3-year period. They divided their patient groups into those who had an anesthesia start time between 6:00 a.m. and 4:00 p.m. and those who had an anesthesia start time between 4:01 p.m. and 5:59 a.m. In the original sample and propensity-score-matched groups, the authors examined the effects of start time on morbidity, mortality, and several metrics of hospital length of stay. The start time of elective cardiac surgery did not have a statistically significant effect upon mortality, individual or composite morbidity, or hospital length of stay in either the original sample or the propensity-score-matched sample. The authors' results suggested that elective cardiac surgery may be performed late at night without adverse effects, although institutional support for this effort (such as 24-hour intensivist coverage to facilitate fast-track extubation) may have been integral to their findings.