Korean Circulation Journal

  • 제54권3호
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  • Pages.126-137
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  • 2024
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  • 1738-5520(pISSN)
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  • 1738-5555(eISSN)
대한심장학회 (The Korean Society of Cardiology)
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Off-hours Surgery and Mortality in Patients With Type A Aortic Dissection Repair: A Systematic Review and Meta-Analysis

  • Peter Pin-Sung Liu (Institute of Medical Sciences, Tzu Chi University) ;
  • Jui-Chih Chang (Department of Surgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation) ;
  • Jin-Yi Hsu (Center for Aging and Health, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation) ;
  • Huei-Kai Huang (School of Medicine, Tzu Chi University) ;
  • Ching-Hui Loh (Institute of Medical Sciences, Tzu Chi University) ;
  • Jih-I Yeh (Institute of Medical Sciences, Tzu Chi University)
  • 투고 : 2023.09.18
  • 심사 : 2023.12.20
  • 발행 : 2024.03.01
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초록

Background and Objectives: The impact of off-hours admission (such as weekends, nighttime, and non-working hours) vs. regular hours (weekdays and daytime working hours) on the mortality risk of patients undergoing surgery for type A aortic dissection (TAAD) repair is still uncertain. To address this uncertainty, we undertook a comprehensive systematic review and meta-analysis. We aimed to assess the potential link between off-hours admission and the risk of mortality in patients undergoing TAAD repair surgery. Methods: We conducted a thorough search of the PubMed, Embase, and Cochrane Library databases, covering the period from their inception to May 20, 2023. Our inclusion criteria encompassed all studies that examined the potential relationship between off-hour admission and mortality in individuals who had undergone surgery for TAAD repair. The odds ratios (ORs) were extracted and combined utilizing a random effects model for our synthesis. Results: Nine studies with 16,501 patients undergoing TAAD repair surgery were included in the meta-analysis. Overall, patients who underwent surgery during the weekend had higher in-hospital mortality (pooled OR, 1.41; 95% confidence interval [CI], 1.14-1.75; p=0.002) than those treated on weekdays. However, the mortality risks among patients who underwent TAAD surgery during nighttime and non-working hours were not significantly elevated compared to daytime and working hours admission. Conclusions: Weekend surgery for TAAD was associated with a higher in-hospital mortality risk than weekday surgery. However, further studies are warranted to identify and develop strategies to improve the quality of round-the-clock care for patients with TAAD.

키워드

과제정보

The authors thank the Health and Welfare Data Science Center, Ministry of Health and Welfare, Taiwan, for maintaining and processing the data, and the Health and Welfare Data Science Center of Tzu Chi University for facilitating the data extraction.

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