Evidence map›Paper›PMID 30766615›Full record

ArticlePatient safety in surgery2019

Does the time of day in orthopedic trauma surgery affect mortality and complication rates?

Sascha Halvachizadeh, Henrik Teuber, Paolo Cinelli, Florin Allemann, Hans-Christoph Pape, Valentin Neuhaus

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Patient safety in surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Observational
  5. Balancing Objectivity and Humanity: Ethical Challenges and Considerations in Surgical Candidacy Decisions.HEC forum : an interdisciplinary journal on hospitals' ethical and legal issues · 2026
    Article
  6. Observational
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  10. Observational
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  12. Article
  13. Article
  14. Article
  15. Review
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  17. Article
  18. A Solution to After-Hours Fatigue and Surgical Backlog.Geriatric orthopaedic surgery & rehabilitation · 2021
    Article
  19. Article
  20. The impact of tiredness on virtual reality robotic surgical skills.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2020
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Sascha HalvachizadehDepartment of Trauma, University Hospital Zurich, University of Zurich, Rämistrasse 100, CH-8091 Zurich, ZH Switzerland.ORCID 0000-0003-1393-3232
Henrik TeuberDepartment of Trauma, University Hospital Zurich, University of Zurich, Rämistrasse 100, CH-8091 Zurich, ZH Switzerland.
Paolo CinelliDepartment of Trauma, University Hospital Zurich, University of Zurich, Rämistrasse 100, CH-8091 Zurich, ZH Switzerland.
Florin AllemannDepartment of Trauma, University Hospital Zurich, University of Zurich, Rämistrasse 100, CH-8091 Zurich, ZH Switzerland.
Hans-Christoph PapeDepartment of Trauma, University Hospital Zurich, University of Zurich, Rämistrasse 100, CH-8091 Zurich, ZH Switzerland.
Valentin NeuhausDepartment of Trauma, University Hospital Zurich, University of Zurich, Rämistrasse 100, CH-8091 Zurich, ZH Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOrthopedic trauma surgery has multiple, both patient-based and surgeon-based risk factors. Evaluating and modifying certain patient safety factors could mitigate some of these risks. This study investigates the influence that the time of day of surgery has on mortality and complication rates. QUESTION/PURPOSE: This study evaluates whether the time of day of orthopedic trauma surgery influences complication or mortality rates. PATIENTS AND

methodsA prospective Swiss surgical database developed as a nationwide quality assurance project was reviewed retrospectively. All patients with trauma-coded diagnoses that were surgically treated in Swiss hospitals between 2004 and 2014 were evaluated. Surgery times were stratified into morning, afternoon, evening and night. The primary outcomes were in-hospital mortality and complication rates. Co-factors were sought in bivariate and multivariable analysis.

resultsOf 31,692 patients, 13,969 (44.3%) were operated in the morning, 12,696 (40.3%) in the afternoon, 4,331 (13.7%) in the evening, and 550 (1.7%) at night. Mortality rates were significantly higher in nighttime (2.4%, OR 1.26,

conclusionThis study observed higher complication and mortality rates for surgery performed after-hours, which correlates with other recent studies. Surgeon fatigue is a potential contributing factor for these increased risks. Other potential factors include surgeon experience, surgery type, and the potential for more severe or emergent injuries occurring after-hours.

Indexed as

Time of surgery, Complications, Mortality, Trauma surgery

Identifiers

PMID30766615
PMCPMC6362600

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.