• Association Between Surgical S...

Treffer: Association Between Surgical Start Time and Major Morbidity or Mortality After Pulmonary Resection.

Title:
Association Between Surgical Start Time and Major Morbidity or Mortality After Pulmonary Resection.
Authors:
Khan AA; Department of Cardiovascular and Thoracic Surgery, Rush University Medical Center, Chicago, Illinois., Shah SK; Department of Cardiovascular and Thoracic Surgery, Rush University Medical Center, Chicago, Illinois., Adebayo OW; Department of Medicine, Rush University Medical Center, Chicago, Illinois., Brooks C; Department of Medicine, University of Illinois Chicago, Chicago, Illinois., Ansari M; Department of Cardiovascular and Thoracic Surgery, Rush University Medical Center, Chicago, Illinois., Basu S; Department of Medicine, Rush University Medical Center, Chicago, Illinois., Geissen NM; Department of Cardiovascular and Thoracic Surgery, Rush University Medical Center, Chicago, Illinois., Alex G; Department of Cardiovascular and Thoracic Surgery, Rush University Medical Center, Chicago, Illinois., Liptay MJ; Department of Cardiovascular and Thoracic Surgery, Rush University Medical Center, Chicago, Illinois., Seder CW; Department of Cardiovascular and Thoracic Surgery, Rush University Medical Center, Chicago, Illinois. Electronic address: christopher_w_seder@rush.edu.
Source:
The Annals of thoracic surgery [Ann Thorac Surg] 2026 Jan; Vol. 121 (1), pp. 196-204. Date of Electronic Publication: 2025 May 28.
Publication Type:
Journal Article
Language:
English
Journal Info:
Publisher: Elsevier Country of Publication: Netherlands NLM ID: 15030100R Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1552-6259 (Electronic) Linking ISSN: 00034975 NLM ISO Abbreviation: Ann Thorac Surg Subsets: MEDLINE
Imprint Name(s):
Publication: Amsterdam : Elsevier
Original Publication: Boston.
MeSH Terms:
Pneumonectomy*/methods , Pneumonectomy*/adverse effects , Lung Neoplasms*/surgery , Lung Neoplasms*/mortality , Postoperative Complications*/epidemiology , Carcinoma, Non-Small-Cell Lung*/surgery , Carcinoma, Non-Small-Cell Lung*/mortality , Operative Time*, Humans ; Female ; Male ; Aged ; Middle Aged ; Retrospective Studies ; Morbidity/trends ; Time Factors ; Incidence
Entry Date(s):
Date Created: 20250530 Date Completed: 20251220 Latest Revision: 20251220
Update Code:
20251221
DOI:
10.1016/j.athoracsur.2025.05.011
PMID:
40446892
Database:
MEDLINE

Weitere Informationen

Background: The objective of this study was to examine the association between the operative start time of pulmonary resections and the incidence of major morbidity or mortality after resection.
Methods: The Society of Thoracic Surgeons General Thoracic Surgery Database was queried for patients who underwent lobar or sublobar pulmonary resections for non-small cell lung cancer between 2015 and 2023. Exclusion criteria included missing data on 30-day mortality, sex, and tumor staging, emergent cases, multiple primary procedures, and an American Society of Anesthesiologists score ≥IV or Eastern Cooperative Oncology Group score of ≥4. Open and minimally invasive surgery (MIS) cohorts were analyzed separately. Patients were divided into "early" and "late" groups according to whether the operative start time was before or after 4 cutoff times: 8 am, 12 pm, 3 pm, and 6 pm. Propensity matching was performed for each cutoff. Univariable and multivariable logistic regression analyses were used to evaluate associations between operative start times and the composite outcome of 30-day major morbidity or mortality.
Results: A total of 115,020 patients met the inclusion criteria, with a median age of 69 years (interquartile range, 62-74 years); of these, 59% (n = 67,553) were women, and 88% (n = 101,103) underwent MIS resections. The overall mortality rate was 0.8% (895 of 115,020), and the major morbidity rate was 6.4% (7312 of 115,020). After propensity matching in the MIS and open cohorts, no association was found between later operative start times and major morbidity or mortality using cutoffs of 8 am, 12 pm, 3pm, or 6 pm.
Conclusions: No association was found between operative start time and the incidence of major morbidity or mortality.
(Copyright © 2025 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)

Disclosures The authors have no conflicts of interest to disclose.