title: Surgery Start Time Does Not Impact Outcome in Elective Cardiac Surgery.
abstract: OBJECTIVE
  Determine if surgery start time impacts patient outcomes in elective cardiac surgery.
  
  
  METHODS
  This was a retrospective study.
  
  
  METHODS
  This study was based at a single academic institution.
  
  
  METHODS
  Patients undergoing elective cardiac surgery over a 3-year period were included.
  
  
  METHODS
  There were no interventions.
  
  
  RESULTS
  The authors performed a retrospective study of patients undergoing elective cardiac surgery over a 3-year period. They divided their patient groups into those who had an anesthesia start time between 6:00 a.m. and 4:00 p.m. and those who had an anesthesia start time between 4:01 p.m. and 5:59 a.m. In the original sample and propensity-score-matched groups, the authors examined the effects of start time on morbidity, mortality, and several metrics of hospital length of stay. The start time of elective cardiac surgery did not have a statistically significant effect upon mortality, individual or composite morbidity, or hospital length of stay in either the original sample or the propensity-score-matched sample.
  
  
  CONCLUSIONS
  The authors' results suggested that elective cardiac surgery may be performed late at night without adverse effects, although institutional support for this effort (such as 24-hour intensivist coverage to facilitate fast-track extubation) may have been integral to their findings.
authors.affiliation: Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, NY. Electronic address: Joshua.heller@mountsinai.org.
authors.forename: Joshua A
authors.initials: JA
authors.lastname: Heller
authors.affiliation: Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Rishi
authors.initials: R
authors.lastname: Kothari
authors.affiliation: Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Hung-Mo
authors.initials: HM
authors.lastname: Lin
authors.affiliation: Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Levin
authors.affiliation: Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Menachem
authors.initials: M
authors.lastname: Weiner
mesh_terms: D039602:After-Hours Care / Q000592:standards* / Q000706:statistics & numerical data; D000368:Aged; D000776:Anesthesiology / Q000458:organization & administration; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000401:mortality / Q000592:standards; D017558:Elective Surgical Procedures / Q000009:adverse effects* / Q000401:mortality / Q000592:standards; D005260:Female; D006302:Health Services Research / Q000379:methods; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration; D011182:Postoperative Care / Q000379:methods; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
keywords: anesthesiology; cardiac surgical procedures; hospital mortality; length of stay; operative time