BACKGROUND: Previous studies in the field of organ transplantation have shown a possible association between nighttime surgery and adverse outcomes. We aim to determine the impact of nighttime lung transplantation on postoperative outcomes, long-term survival, and overall cost. METHODS: We performed a single-center retrospective cohort analysis of adult lung transplant recipients who underwent transplantation between January 2006 and December 2017. Data were extracted from our institutional Lung Transplant Registry and Mid-America Transplant services database. Patients were classified into 2 strata, daytime (5 AM to 6 PM) and nighttime (6 PM to 5 AM), based on time of incision. Major postoperative adverse events, 5-year overall survival, and 5-year bronchiolitis obliterans syndrome-free survival were examined after propensity score matching. Additionally we compared overall cost of transplantation between nighttime and daytime groups. RESULTS: Of the 740 patients included in this study, 549 (74.2%) underwent daytime transplantation and 191 (25.8%) underwent nighttime transplantation (NT). Propensity score matching yielded 187 matched pairs. NT was associated with a higher risk of having any major postoperative adverse event (adjusted odds ratio, 1.731; 95% confidence interval, 1.093-2.741; P = .019), decreased 5-year overall survival (adjusted hazard ratio, 1.798; 95% confidence interval, 1.079-2.995; P = .024), and decreased 5-year bronchiolitis obliterans syndrome-free survival (adjusted hazard ratio, 1.556; 95% confidence interval, 1.098-2.205; P = .013) in doubly robust multivariable analyses after propensity score matching. Overall cost for NT and daytime transplantation was similar. CONCLUSIONS: NT was associated with a higher risk of major postoperative adverse events, decreased 5-year overall survival, and decreased 5-year bronchiolitis obliterans syndrome-free survival. Our findings suggest potential benefits of delaying NT to daytime transplantation.
BACKGROUND: Previous studies in the field of organ transplantation have shown a possible association between nighttime surgery and adverse outcomes. We aim to determine the impact of nighttime lung transplantation on postoperative outcomes, long-term survival, and overall cost. METHODS: We performed a single-center retrospective cohort analysis of adult lung transplant recipients who underwent transplantation between January 2006 and December 2017. Data were extracted from our institutional Lung Transplant Registry and Mid-America Transplant services database. Patients were classified into 2 strata, daytime (5 AM to 6 PM) and nighttime (6 PM to 5 AM), based on time of incision. Major postoperative adverse events, 5-year overall survival, and 5-year bronchiolitis obliterans syndrome-free survival were examined after propensity score matching. Additionally we compared overall cost of transplantation between nighttime and daytime groups. RESULTS: Of the 740 patients included in this study, 549 (74.2%) underwent daytime transplantation and 191 (25.8%) underwent nighttime transplantation (NT). Propensity score matching yielded 187 matched pairs. NT was associated with a higher risk of having any major postoperative adverse event (adjusted odds ratio, 1.731; 95% confidence interval, 1.093-2.741; P = .019), decreased 5-year overall survival (adjusted hazard ratio, 1.798; 95% confidence interval, 1.079-2.995; P = .024), and decreased 5-year bronchiolitis obliterans syndrome-free survival (adjusted hazard ratio, 1.556; 95% confidence interval, 1.098-2.205; P = .013) in doubly robust multivariable analyses after propensity score matching. Overall cost for NT and daytime transplantation was similar. CONCLUSIONS: NT was associated with a higher risk of major postoperative adverse events, decreased 5-year overall survival, and decreased 5-year bronchiolitis obliterans syndrome-free survival. Our findings suggest potential benefits of delaying NT to daytime transplantation.
Authors: Timothy J George; George J Arnaoutakis; Christian A Merlo; Clinton D Kemp; William A Baumgartner; John V Conte; Ashish S Shah Journal: JAMA Date: 2011-06-01 Impact factor: 56.272
Authors: Charles M Balch; Tait D Shanafelt; Lotte Dyrbye; Jeffrey A Sloan; Thomas R Russell; Gerald J Bechamps; Julie A Freischlag Journal: J Am Coll Surg Date: 2010-09-20 Impact factor: 6.113
Authors: B E Lonze; A Parsikia; E L Feyssa; K Khanmoradi; V R Araya; R F Zaki; D L Segev; J A Ortiz Journal: Am J Transplant Date: 2010-08 Impact factor: 8.086
Authors: Patrick R Aguilar; Bradford C Bemiss; Chad Witt; Derek E Byers; Daniel Kreisel; Varun Puri; Bryan Meyers; G Alexander Patterson; Alexander S Krupnick; Roger D Yusen; Elbert P Trulock; Ramsey R Hachem Journal: Ann Thorac Surg Date: 2017-08-16 Impact factor: 4.330
Authors: Stefana Rafiroiu; Habiba Hassouna; Usman Ahmad; Christine Koval; Kenneth R McCurry; Gösta B Pettersson; Mudathir Ibrahim; Douglas R Johnston; Marie Budev; Sudish C Murthy; Andrew J Toth; Eugene H Blackstone; Michael Z Tong Journal: Ann Thorac Surg Date: 2019-09-14 Impact factor: 4.330
Authors: Stephanie H Chang; Daniel Kreisel; Gary F Marklin; Lindsey Cook; Ramsey Hachem; Benjamin D Kozower; Keki R Balsara; Jennifer M Bell; Christine Frederiksen; Bryan F Meyers; G Alexander Patterson; Varun Puri Journal: Ann Thorac Surg Date: 2018-01-11 Impact factor: 4.330
Authors: Christian Corbin Frye; Jason M Gauthier; Amit Bery; William D Gerull; Deniz B Morkan; Jingxia Liu; M Shea Harrison; Yuriko Terada; Judith E Van Zanden; Gary F Marklin; Michael K Pasque; Ruben G Nava; Bryan F Meyers; Alexander G Patterson; Benjamin D Kozower; Ramsey Hachem; Derek Byers; Chad Witt; Hrishikesh Kulkarni; Daniel Kreisel; Varun Puri Journal: Clin Transplant Date: 2020-12-14 Impact factor: 2.863
Authors: Hailey M Shepherd; Ramsey R Hachem; Chad A Witt; Rodrigo V Guillamet; Derek E Byers; Benjamin D Kozower; Bryan F Meyers; Tsuyoshi Takahashi; G Alexander Patterson; Varun Puri; Daniel Kreisel; Ruben G Nava Journal: J Thorac Dis Date: 2022-08 Impact factor: 3.005