Evidence map›Paper›PMID 39182555›Full record

ArticleThe Annals of thoracic surgery2025

Does Timing Matter? The Effect of Intensive Care Unit Arrival Timing on Elective Cardiac Surgery.

Alex M Wisniewski, Sanjana Challa, Raymond J Strobel, Anthony V Norman, Leora T Yarboro, Kenan Yount, John Kern, Michael Mazzeffi, Nicholas R Teman

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in The Annals of thoracic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Alex M WisniewskiDivision of Cardiothoracic Surgery, Department of Surgery, University of Virginia Health System, Charlottesville, Virginia. Electronic address: amw4gg@uvahealth.org.
Sanjana ChallaDivision of Cardiothoracic Surgery, Department of Surgery, University of Virginia Health System, Charlottesville, Virginia.
Raymond J StrobelDivision of Cardiothoracic Surgery, Department of Surgery, University of Virginia Health System, Charlottesville, Virginia.
Anthony V NormanDivision of Cardiothoracic Surgery, Department of Surgery, University of Virginia Health System, Charlottesville, Virginia.
Leora T YarboroDivision of Cardiothoracic Surgery, Department of Surgery, University of Virginia Health System, Charlottesville, Virginia.
Kenan YountDivision of Cardiothoracic Surgery, Department of Surgery, University of Virginia Health System, Charlottesville, Virginia.
John KernDivision of Cardiothoracic Surgery, Department of Surgery, University of Virginia Health System, Charlottesville, Virginia.
Michael MazzeffiDepartment of Anesthesiology, University of Virginia, Charlottesville, Virginia.
Nicholas R TemanDivision of Cardiothoracic Surgery, Department of Surgery, University of Virginia Health System, Charlottesville, Virginia.

Funding

Cardiovascular Surgery Training ProgramT32HL007849 · NHLBI · UNIVERSITY OF VIRGINIA CHARLOTTESVILLE · PI KRON, IRVING L., LAUBACH, VICTOR E · 1998 to 2025
$7.0M
NHLBI NIH HHS T32 HL007849
6 · The paper itself

Abstract

backgroundDue to staffing changes at scheduled intervals and decreases in essential staff in the evenings, late intensive care unit (ICU) arrivals may be at risk for suboptimal outcomes. Utilizing a regional collaborative, we sought to determine the effect of ICU arrival timing on outcomes in elective isolated coronary artery bypass.

methodsAdults undergoing elective, isolated coronary artery bypass from 17 hospitals between 2013 and 2023 were identified. Patients with missing predicted risk of mortality or missing ICU arrival time were excluded. Late ICU arrival time was defined as between 6:00 pm and 6:00 am. Hierarchical logistic regression with appropriate predicted risk scores was utilized for outcome risk adjustment.

resultsWe identified 11,638 patients, with 972 (8.4%) experiencing late ICU arrival. Late ICU arrival patients had higher predicted risk of morbidity or mortality (8.2%; [interquartile range {IQR}, 5.6%, 12.0%] vs 7.7% [IQR, 5.5%, 11.5%], P = .048) compared with early ICU arrival patients with longer median cardiopulmonary bypass times (96 minutes [IQR, 78, 119] vs 93 [IQR, 73, 116], P < .001). Late ICU arrival patients experienced more unadjusted complications including prolonged ventilation (7.7% vs 4.2%, P < .001) and operative mortality (2.0% vs 1.1%, P = .02), although no difference in failure-to-rescue (11.0% vs 10.4%, P = .84). Logistic regression with risk adjustment demonstrated late ICU arrival as a predictor of prolonged ventilation (odds ratio, 1.49 [95% CI, 1.12-1.99], P = .006).

conclusionsAfter adjustment, late ICU arrivals experienced higher rates of prolonged ventilation, although this did not translate to failure-to-rescue.

Indexed as

Coronary Artery BypassElective Surgical ProceduresIntensive Care UnitsAgedFemaleHospital MortalityHumansMaleMiddle AgedRetrospective StudiesTime Factors

Identifiers

PMID39182555
PMCPMC11741921

What OpenQuestion holds

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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.