Dataset Information

Impact of Nighttime Lung Transplantation on Outcomes and Costs.

ABSTRACT:

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.

SUBMITTER: Yang Z

PROVIDER: S-EPMC8041913 | biostudies-literature | 2021 Jul

REPOSITORIES: biostudies-literature

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Publications

Impact of Nighttime Lung Transplantation on Outcomes and Costs.

Yang Zhizhou Z Takahashi Tsuyoshi T Gerull William D WD Hamilton Christy C Subramanian Melanie P MP Liu Jingxia J Meyers Bryan F BF Kozower Benjamin D BD Patterson G Alexander GA Nava Ruben G RG Hachem Ramsey R RR Witt Chad A CA Aguilar Patrick R PR Pasque Michael K MK Byers Derek E DE Kulkarni Hrishikesh S HS Kreisel Daniel D Puri Varun V

The Annals of thoracic surgery 20201013 1

<h4>Background</h4>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.<h4>Methods</h4>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 insti ...[more]

PMID: 33065051

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Dataset Information

Impact of Nighttime Lung Transplantation on Outcomes and Costs.

Background

Methods

Results

Conclusions

Publications

Impact of Nighttime Lung Transplantation on Outcomes and Costs.

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