title: Middle-of-the-night PCI does not affect subsequent day PCI success and complication rates by the same operator.
abstract: OBJECTIVE
  To determine the impact of percutaneous coronary interventions (PCI) performed during late-night hours on next day PCI performance by the same interventional cardiologist.
  
  
  BACKGROUND
  There is little data regarding the effects of sleep deprivation on interventional cardiologists performing PCIs.
  
  
  METHODS
  All primary PCIs from January 1, 2005 to December 31, 2009 between 11 PM and 7 AM were identified. All PCIs performed during the subsequent work day by the same interventionists were included in the sleep-deprived group. All other PCIs were included in the non-sleep-deprived group. Data were entered prospectively into the American College of Cardiology National Cardiovascular Data Registry (NCDR). The two groups were compared with respect to efficacy and safety endpoints.
  
  
  RESULTS
  During the 5-year period, 3,944 PCIs were performed by four operators, including 3,644 non-sleep-deprived cases and 167 sleep-deprived cases. The two groups were similar with respect to demographics, comorbidities, and procedural characteristics. There were more intraprocedural deaths in the sleep-deprived group (1.2% vs. 0.2%, P = 0.04); however, the adjusted odds ratio (OR) was nonsignificant (OR = 6.83, 95% confidence interval [CI] = 0.66-39.63, P = 0.11). Excessive bleeding at the arterial access site in the non-sleep-deprived group was more frequent (2.7% vs. 0%, P = 0.02). There were no differences in the combined safety or efficacy endpoints between the two groups.
  
  
  CONCLUSIONS
  In this single-center study, we found no evidence that middle-of-the night procedures adversely affect safety or efficacy of procedures done the next day by the same operator.
authors.affiliation: Department of Cardiology, Geisinger Medical Center, Danville, Pennsylvania 17822, USA. vcrudu1@geisinger.edu
authors.forename: Vitalie
authors.initials: V
authors.lastname: Crudu
authors.forename: Jennifer
authors.initials: J
authors.lastname: Sartorius
authors.forename: Peter
authors.initials: P
authors.lastname: Berger
authors.forename: Thomas
authors.initials: T
authors.lastname: Scott
authors.forename: Kimberly
authors.initials: K
authors.lastname: Skelding
authors.forename: James
authors.initials: J
authors.lastname: Blankenship
mesh_terms: D039602:After-Hours Care; D000368:Aged; D016009:Chi-Square Distribution; D002983:Clinical Competence; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010414:Pennsylvania; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000401:mortality; D010561:Personnel Staffing and Scheduling; D011446:Prospective Studies; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D012892:Sleep Deprivation; D013647:Task Performance and Analysis; D013997:Time Factors; D016896:Treatment Outcome