ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2019
'After-hours' non-elective spine surgery is associated with increased perioperative adverse events in a quaternary center.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 18 citations in OpenAlex.
- Association Between Surgical Timing and Perioperative Outcomes in Lumbar Spine Surgery: A Retrospective Cohort Study.Journal of clinical medicine · 2026Article
- Adverse event severity in weekend and after-hours interventional radiology: a multi-institutional quality review.CVIR endovascular · 2026Article
- Time-of-Day-Dependent Post-Induction Hypotension and Personalized Hemodynamic Management in Emergency Spine Surgery: A Retrospective Pre-Post Cohort Study.Medicina (Kaunas, Lithuania) · 2026Article
- Out-of-hours emergent surgery for degenerative spinal disease in Canada: a retrospective cohort study from a national registry.Lancet regional health. Americas · 2024Article
- Clinical Characteristics, Surgical Outcomes, and Risk Factors for Emergency Surgery in Patients With Spinal Metastases: A Prospective Cohort Study.Neurospine · 2024Article
- Enhancing the referral process for surgical management of spinal metastases: insights from a 12-year, bi-institutional study of 533 patients.Frontiers in oncology · 2024Article
- Comparing 30-Day Outcomes After Emergent Spine Procedures Performed "During Hours" vs "After Hours".International journal of spine surgery · 2023Article
- Encrypted smartphone text messaging between spine surgeons may reduce after-hours surgery.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2022Article
- Association Between Daytime vs Overnight Digit Replantation and Surgical Outcomes.JAMA network open · 2022Article
- Degenerative spinal conditions requiring emergency surgery: an evolving crisis in a publicly funded health care system.Canadian journal of surgery. Journal canadien de chirurgieArticle
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purpose'After-hours' non-elective spinal surgeries are frequently necessary, and often performed under sub-optimal conditions. This study aimed (1) to compare the characteristics of patients undergoing non-elective spine surgery 'After-hours' as compared to 'In-hours'; and (2) to compare the perioperative adverse events (AEs) between those undergoing non-elective spine surgery 'after-hours' as compared to 'in-hours'.
methodsIn this retrospective study of a prospective non-elective spine surgery cohort performed in a quaternary spine center, surgery was defined as 'in-hours' if performed between 0700 and 1600 h from Monday to Friday or 'after-hours' if more than 50% of the operative time occurred between 1601 and 0659 h, or if performed over the weekend. The association of 'after-hours' surgery with AEs, surgical duration, intraoperative estimated blood loss (IOBL), length of stay and in-hospital mortality was analyzed using stepwise multivariate logistic regression.
resultsA total of 1440 patients who underwent non-elective spinal surgery between 2009 and 2013 were included in this study. A total of 664 (46%) procedures were performed 'after-hours'. Surgical duration and IOBL were similar. About 70% of the patients operated 'after-hours' experienced at least one AE compared to 64% for the 'in-hours' group (p = 0.016). 'After-hours' surgery remained an independent predictor of AEs on multivariate analysis [adjusted OR 1.30, 95% confidence interval (CI) 1.02-1.66, p = 0.034]. In-hospital mortality increased twofold in patients operated 'after-hours' (4.4% vs. 2.1%, p = 0.013). This association lost significance on multivariate analysis (adjusted OR 1.99, 95% CI 0.98-4.06, p = 0.056).
conclusionNon-elective spine surgery performed 'after-hours' is independently associated with increased risk of perioperative adverse events, length of stay and possibly, mortality. Research is needed to determine the specific factors contributing to poorer outcomes with 'after-hours' surgery and strategies to minimize this risk. These slides can be retrieved under Electronic Supplementary Material.
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