ArticleCanadian journal of surgery. Journal canadien de chirurgie2020
Operative timing is associated with increased morbidity and mortality in patients undergoing emergency general surgery: a multisite study of emergency general services in a single academic network.
Article in Canadian journal of surgery. Journal canadien de chirurgie, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
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Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 25 citations in OpenAlex.
- Outcomes following out-of-hours acute appendectomy: a systematic review and meta-analysis.Langenbeck's archives of surgery · 2026Pooled it
- Daytime versus nighttime appendectomy in term of complications and clinical outcomes: a meta-analysis.International journal of colorectal disease · 2024Pooled it
- Association Between Surgical Timing and Perioperative Outcomes in Lumbar Spine Surgery: A Retrospective Cohort Study.Journal of clinical medicine · 2026Article
- In-hospital Wait Times for Emergency General Surgery: Do Immigrants Wait Longer?Journal of immigrant and minority health · 2026Article
- A Review of Current Literature of Interest to the Office-Based Anesthesiologist.Anesthesia progress · 2024Article
- Evaluation of the practice of reprocessing ORs in German hospitals from an infection prevention and control perspective.Infection · 2024Article
- The Operating Room management for emergency Surgical Activity (ORSA) study: a WSES international survey.Updates in surgery · 2024Article
- Association between timing of operative interventions and mortality in emergency general surgery.Trauma surgery & acute care open · 2024Article
- Clinical Outcomes of Daytime Versus Nighttime Laparoscopic Appendectomy in Children.Children (Basel, Switzerland) · 2023Article
- Potential Access to Emergency General Surgical Care in Ontario.International journal of environmental research and public health · 2022Article
- Clinical Impact of a Quality Improvement Program Including Dedicated Emergency Radiology Personnel on Emergency Surgical Management: A Propensity Score-Matching Study.Korean journal of radiology · 2022Article
- Impact of the acute care surgery model on resident operative experience in emergency general surgery.Canadian journal of surgery. Journal canadien de chirurgie · 2021Article
- A model-based validation study of postoperative complications with considerations on operative timing.Annals of translational medicine · 2021Article
- Operating room use for emergency general surgery cases: analysis of the Patterns of Complex Emergency General Surgery in Canada study.Canadian journal of surgery. Journal canadien de chirurgieArticle
- Delays in presentation, severity of illness, and adverse surgical outcomes among patients transferred from Nunavik for acute care surgery.Canadian journal of surgery. Journal canadien de chirurgieArticle
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Despite the widespread implementation of the acute care surgery (ACS) model, limited access to operating room time represents a barrier to the optimal delivery of emergency general surgery (EGS) care. The objective of this study was to describe the effect of operative timing on outcomes in EGS in a network of teaching hospitals. Methods: We conducted a retrospective review of EGS operations performed at 3 teaching hospitals in a single academic network. Time of operation was categorized as daytime (8 am to 5 pm), after hours (5 pm to 11 pm) or overnight (11 pm to 8 am). Time to operation was calculated as the interval from admission to operative start time and categorized as less than 24 hours, 24-72 hours and greater than 72 hours. Results: After we excluded nonindex cases, trauma cases and cases occurring more than 5 days after admission, 1505 EGS cases were included. We found that 39.0% of operations were performed in the daytime, 46.3% after hours and 14.8% overnight. In terms of time to operation, 52.3% of operations were performed within 24 hours of admission, 33.4% in 24-72 hours and 14.3% in more than 72 hours. The overall complication rate was 20.6% (310 patients) and the overall mortality rate was 3.8% (57 patients). After multivariable analysis, time to operation more than 72 hours after admission was independently associated with increased odds of morbidity (odds ratio [OR] 1.64, 95% confidence interval [CI] 1.09-2.47), while overnight operating was associated with increased odds of death (OR 3.15, 95% CI 1.29-7.70). Conclusion: Increasing time from admission to operation and overnight operating were associated with greater morbidity and mortality, respectively, for EGS patients. Strategies to provide timely access to the operating room should be considered to optimize care in an ACS model.
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