Daytime variation does not impact outcome of cardiac surgery: Results from a diverse, multi-institutional cardiac surgery network

ObjectiveRecent single-center and experimental data suggested greater adverse cardiac events for patients undergoing aortic valve replacement (AVR) in the morning (AM) versus afternoon (PM). However, previous studies coronary artery bypass grafting (CABG) have found no similar time-related difference. We examined impact of AM PM operative time on surgical outcomes CABG AVR a diverse, multi-institutional surgery network between January 2008 September 2018.MethodsThe group included whose start was 6:30 9 AM, whereas noon to 2:30 considered (8901 AM/1962 PM) (2598 AM/617 AVR. Because imbalances sample size, risk factors, Society Thoracic Surgeons predicted groups, propensity score matching using all baseline characteristics used create 2 well-matched patient groups were compared.ResultsAfter matching, there difference mortality, stroke, prolonged ventilation, renal failure, deep sternal wound infection, reoperation, myocardial injury, atrial fibrillation, or readmission both isolated mixed differences noted intensive care unit length stay, postoperative blood product use, crossclamp time. Findings stable when accounting site physician effects, subgroup analyses showed findings elective, diabetic, Hispanic, off-pump populations.ConclusionsThere mortality nor major morbidity either