• Trine G Eskesen, Thomas Peponis, Noelle Saillant, David R King, Peter J Fagenholz, George C Velmahos, and Kaafarani Haytham M A HMA Division of Trauma, Emergency Surgery & Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, 1.
• Division of Trauma, Emergency Surgery & Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, 165 Cambridge Street, Suite 810, Boston, MA, 02114, USA.
• Am. J. Surg. 2018 Jul 1; 216 (1): 19-24.

BackgroundWe sought to investigate the association between nighttime (NT) operating and the occurrence of intraoperative adverse events (iAEs).Study DesignOur 2007-2012 institutional ACS-NSQIP and administrative databases were screened for iAEs using the ICD-9-CM-based Patient Safety Indicator "accidental puncture or laceration". Procedures were defined as AM (06.00-14.00 h), PM (14.00-22.00 h), or NT (22.00-06.00 h). Univariate and multivariable analyses were performed to investigate the association between PM and NT operating and the occurrence of iAEs.Results9136 surgical procedures were included: 7445 AM, 1303 PM, 388 NT. iAEs occurred in 183 procedures. NT patients were younger and less comorbid, but sicker, and with less complex surgeries. There was no correlation between PM or NT operations and iAEs (multivariable analysis [reference: AM operations]: OR = 0.66 [95% CI = 0.40-1.12], P = 0.123; OR = 1.22 [95% CI = 0.51-2.93], P = 0.659, respectively).ConclusionOperating at night does increase the risk of iAEs.Copyright © 2017 Elsevier Inc. All rights reserved.

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