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Analysis of the Effects of Day-Time vs. Night-Time Surgery on Renal Transplant Patient Outcomes

Sleep deprivation and disruption of the circadian rhythms could impair individual surgical performance and decision making. For this purpose, this study identified potential confounding factors on surgical renal transplant patient outcomes during day and night. Our retrospective cohort study of 215...

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Autores principales: Sugünes, Nesrin, Bichmann, Anna, Biernath, Nadine, Peters, Robert, Budde, Klemens, Liefeldt, Lutz, Schlomm, Thorsten, Friedersdorff, Frank
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6678185/
https://www.ncbi.nlm.nih.gov/pubmed/31323849
http://dx.doi.org/10.3390/jcm8071051
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author Sugünes, Nesrin
Bichmann, Anna
Biernath, Nadine
Peters, Robert
Budde, Klemens
Liefeldt, Lutz
Schlomm, Thorsten
Friedersdorff, Frank
author_facet Sugünes, Nesrin
Bichmann, Anna
Biernath, Nadine
Peters, Robert
Budde, Klemens
Liefeldt, Lutz
Schlomm, Thorsten
Friedersdorff, Frank
author_sort Sugünes, Nesrin
collection PubMed
description Sleep deprivation and disruption of the circadian rhythms could impair individual surgical performance and decision making. For this purpose, this study identified potential confounding factors on surgical renal transplant patient outcomes during day and night. Our retrospective cohort study of 215 adult renal cadaver transplant recipients, of which 132 recipients were allocated in the “day-time” group and 83 recipients in the “night-time” group, primarily stratified the patients into two cohorts, depending on the start time. Within a 24 h operational system, “day-time” was considered as being from 8 a.m. to 8 p.m. and “night-time” from 8 p.m. to 8 a.m.. Primary outcomes examined patient and graft survival after three months and one year. Secondary outcomes included the presence of acute rejection (AR) and delayed graft function (DGF), as well as the rate of postoperative complications. In log-rank testing, “day-time” surgery was associated with a significantly higher risk of patient death (p = 0.003), whereas long-term graft survival was unaffected by the operative time of day. The mean cold ischemia time (CIT), which was 12.4 ± 5.3 h in the “night-time” group, was significantly longer compared to 10.7 ± 3.6 for those during the day (p = 0.01). We observed that “night-time” kidney recipients experienced more wound complications. From our single-centre data, we conclude that night-time kidney transplantation does not increase the risk of adverse events or predispose the patient to a worse outcome. Nevertheless, further research is required to explore the effect of fatigue on nocturnal surgical performance.
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spelling pubmed-66781852019-08-19 Analysis of the Effects of Day-Time vs. Night-Time Surgery on Renal Transplant Patient Outcomes Sugünes, Nesrin Bichmann, Anna Biernath, Nadine Peters, Robert Budde, Klemens Liefeldt, Lutz Schlomm, Thorsten Friedersdorff, Frank J Clin Med Article Sleep deprivation and disruption of the circadian rhythms could impair individual surgical performance and decision making. For this purpose, this study identified potential confounding factors on surgical renal transplant patient outcomes during day and night. Our retrospective cohort study of 215 adult renal cadaver transplant recipients, of which 132 recipients were allocated in the “day-time” group and 83 recipients in the “night-time” group, primarily stratified the patients into two cohorts, depending on the start time. Within a 24 h operational system, “day-time” was considered as being from 8 a.m. to 8 p.m. and “night-time” from 8 p.m. to 8 a.m.. Primary outcomes examined patient and graft survival after three months and one year. Secondary outcomes included the presence of acute rejection (AR) and delayed graft function (DGF), as well as the rate of postoperative complications. In log-rank testing, “day-time” surgery was associated with a significantly higher risk of patient death (p = 0.003), whereas long-term graft survival was unaffected by the operative time of day. The mean cold ischemia time (CIT), which was 12.4 ± 5.3 h in the “night-time” group, was significantly longer compared to 10.7 ± 3.6 for those during the day (p = 0.01). We observed that “night-time” kidney recipients experienced more wound complications. From our single-centre data, we conclude that night-time kidney transplantation does not increase the risk of adverse events or predispose the patient to a worse outcome. Nevertheless, further research is required to explore the effect of fatigue on nocturnal surgical performance. MDPI 2019-07-18 /pmc/articles/PMC6678185/ /pubmed/31323849 http://dx.doi.org/10.3390/jcm8071051 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Sugünes, Nesrin
Bichmann, Anna
Biernath, Nadine
Peters, Robert
Budde, Klemens
Liefeldt, Lutz
Schlomm, Thorsten
Friedersdorff, Frank
Analysis of the Effects of Day-Time vs. Night-Time Surgery on Renal Transplant Patient Outcomes
title Analysis of the Effects of Day-Time vs. Night-Time Surgery on Renal Transplant Patient Outcomes
title_full Analysis of the Effects of Day-Time vs. Night-Time Surgery on Renal Transplant Patient Outcomes
title_fullStr Analysis of the Effects of Day-Time vs. Night-Time Surgery on Renal Transplant Patient Outcomes
title_full_unstemmed Analysis of the Effects of Day-Time vs. Night-Time Surgery on Renal Transplant Patient Outcomes
title_short Analysis of the Effects of Day-Time vs. Night-Time Surgery on Renal Transplant Patient Outcomes
title_sort analysis of the effects of day-time vs. night-time surgery on renal transplant patient outcomes
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6678185/
https://www.ncbi.nlm.nih.gov/pubmed/31323849
http://dx.doi.org/10.3390/jcm8071051
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