Comparing short‐term/long‐term outcomes of heart transplants that occur inside and outside of normal working hours
Abstract Aims Heart transplantation involves many factors such as donor selection, recipient management, multidisciplinary assessment, coordination with other organ teams, and transportation. Because of some unpredictable factors, heart transplantation can be conducted at any time of day. The purpos...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-08-01
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| Series: | ESC Heart Failure |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ehf2.13947 |
| _version_ | 1818510513352474624 |
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| author | Hidefumi Nishida Christopher Salerno David Onsager Tae Song Ann Nguyen Jonathan Grinstein Bow Chung Bryan Smith Sara Kalantari Nitasha Sarswat Gene Kim Sean Pinney Valluvan Jeevanandam Takeyoshi Ota |
| author_facet | Hidefumi Nishida Christopher Salerno David Onsager Tae Song Ann Nguyen Jonathan Grinstein Bow Chung Bryan Smith Sara Kalantari Nitasha Sarswat Gene Kim Sean Pinney Valluvan Jeevanandam Takeyoshi Ota |
| author_sort | Hidefumi Nishida |
| collection | DOAJ |
| description | Abstract Aims Heart transplantation involves many factors such as donor selection, recipient management, multidisciplinary assessment, coordination with other organ teams, and transportation. Because of some unpredictable factors, heart transplantation can be conducted at any time of day. The purpose of this study is to investigate if outcomes differ between heart transplants taking place inside or outside of normal working hours. Methods and results We reviewed patients who underwent heart transplantation at our institution from January 2010 to July 2020 (n = 329). Based on the documented start time of the recipient surgeries, the cohort was divided into two groups: working hours (Group A: 7:30 to 17:00; n = 92) and after hours (Group B: 17:00 to 7:30; n = 237). We compared these groups using propensity score matching analysis. After propensity score matching, 78 pairs of patients were successfully matched. We reviewed early and late clinical outcomes including survival. Long‐term survival was compared using the Kaplan–Meier method. In the propensity‐score matched patients, there were no significant differences in the baseline characteristics between two groups. In‐hospital mortality was not significantly different between the two groups (Group A: 6.4% vs. Group B: 2.6%, P = 0.44). Ischaemic time and cross‐clamp time did not differ between the groups. In terms of postoperative complications, there were no significant differences between two groups in stroke (6.4% vs. 3.9%, P = 0.72), primary graft dysfunction requiring extracorporeal membrane oxygenation (5.1% vs. 7.7%, P = 0.75), re‐exploration for bleeding (9.0% vs. 12.8%, P = 0.44), and newly required haemodialysis (7.7% vs. 6.4%, P = 0.75). The survival rate in Group A (88.1% at 1 year, 81.3% at 3 years) was not significantly different from Group B (90.5% at 1 year, 82.3% at 3 years, log rank = 0.96). Conclusion There was no significant difference in clinical outcomes between heart transplants taking place inside or outside of working hours. A high quality of care can be provided for heart transplant patients even during after hours. |
| first_indexed | 2024-12-10T23:21:01Z |
| format | Article |
| id | doaj.art-7cd231ce2ba1409daaa7b75e765e6af6 |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-12-10T23:21:01Z |
| publishDate | 2022-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-7cd231ce2ba1409daaa7b75e765e6af62022-12-22T01:29:43ZengWileyESC Heart Failure2055-58222022-08-01942484249010.1002/ehf2.13947Comparing short‐term/long‐term outcomes of heart transplants that occur inside and outside of normal working hoursHidefumi Nishida0Christopher Salerno1David Onsager2Tae Song3Ann Nguyen4Jonathan Grinstein5Bow Chung6Bryan Smith7Sara Kalantari8Nitasha Sarswat9Gene Kim10Sean Pinney11Valluvan Jeevanandam12Takeyoshi Ota13Department of Surgery The University of Chicago Medicine Chicago IL USADepartment of Surgery The University of Chicago Medicine Chicago IL USADepartment of Surgery The University of Chicago Medicine Chicago IL USADepartment of Surgery The University of Chicago Medicine Chicago IL USADepartment of Medicine The University of Chicago Medicine Chicago IL USADepartment of Medicine The University of Chicago Medicine Chicago IL USADepartment of Medicine The University of Chicago Medicine Chicago IL USADepartment of Medicine The University of Chicago Medicine Chicago IL USADepartment of Medicine The University of Chicago Medicine Chicago IL USADepartment of Medicine The University of Chicago Medicine Chicago IL USADepartment of Medicine The University of Chicago Medicine Chicago IL USADepartment of Medicine The University of Chicago Medicine Chicago IL USADepartment of Surgery The University of Chicago Medicine Chicago IL USADepartment of Surgery The University of Chicago Medicine Chicago IL USAAbstract Aims Heart transplantation involves many factors such as donor selection, recipient management, multidisciplinary assessment, coordination with other organ teams, and transportation. Because of some unpredictable factors, heart transplantation can be conducted at any time of day. The purpose of this study is to investigate if outcomes differ between heart transplants taking place inside or outside of normal working hours. Methods and results We reviewed patients who underwent heart transplantation at our institution from January 2010 to July 2020 (n = 329). Based on the documented start time of the recipient surgeries, the cohort was divided into two groups: working hours (Group A: 7:30 to 17:00; n = 92) and after hours (Group B: 17:00 to 7:30; n = 237). We compared these groups using propensity score matching analysis. After propensity score matching, 78 pairs of patients were successfully matched. We reviewed early and late clinical outcomes including survival. Long‐term survival was compared using the Kaplan–Meier method. In the propensity‐score matched patients, there were no significant differences in the baseline characteristics between two groups. In‐hospital mortality was not significantly different between the two groups (Group A: 6.4% vs. Group B: 2.6%, P = 0.44). Ischaemic time and cross‐clamp time did not differ between the groups. In terms of postoperative complications, there were no significant differences between two groups in stroke (6.4% vs. 3.9%, P = 0.72), primary graft dysfunction requiring extracorporeal membrane oxygenation (5.1% vs. 7.7%, P = 0.75), re‐exploration for bleeding (9.0% vs. 12.8%, P = 0.44), and newly required haemodialysis (7.7% vs. 6.4%, P = 0.75). The survival rate in Group A (88.1% at 1 year, 81.3% at 3 years) was not significantly different from Group B (90.5% at 1 year, 82.3% at 3 years, log rank = 0.96). Conclusion There was no significant difference in clinical outcomes between heart transplants taking place inside or outside of working hours. A high quality of care can be provided for heart transplant patients even during after hours.https://doi.org/10.1002/ehf2.13947HeartTransplantationWorking hoursOutcomeCircadian rhythm |
| spellingShingle | Hidefumi Nishida Christopher Salerno David Onsager Tae Song Ann Nguyen Jonathan Grinstein Bow Chung Bryan Smith Sara Kalantari Nitasha Sarswat Gene Kim Sean Pinney Valluvan Jeevanandam Takeyoshi Ota Comparing short‐term/long‐term outcomes of heart transplants that occur inside and outside of normal working hours ESC Heart Failure Heart Transplantation Working hours Outcome Circadian rhythm |
| title | Comparing short‐term/long‐term outcomes of heart transplants that occur inside and outside of normal working hours |
| title_full | Comparing short‐term/long‐term outcomes of heart transplants that occur inside and outside of normal working hours |
| title_fullStr | Comparing short‐term/long‐term outcomes of heart transplants that occur inside and outside of normal working hours |
| title_full_unstemmed | Comparing short‐term/long‐term outcomes of heart transplants that occur inside and outside of normal working hours |
| title_short | Comparing short‐term/long‐term outcomes of heart transplants that occur inside and outside of normal working hours |
| title_sort | comparing short term long term outcomes of heart transplants that occur inside and outside of normal working hours |
| topic | Heart Transplantation Working hours Outcome Circadian rhythm |
| url | https://doi.org/10.1002/ehf2.13947 |
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