ArticleActa neurochirurgica2025
Nighttime surgery increases complication risk in chronic subdural hematoma: a population-based cohort study.
Article in Acta neurochirurgica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Safety and Efficacy of Nighttime Versus Daytime Radiofrequency Catheter Ablation for Atrial Fibrillation: A Multicenter Cohort Study.Journal of cardiovascular electrophysiology · 2026Article
- Adverse event severity in weekend and after-hours interventional radiology: a multi-institutional quality review.CVIR endovascular · 2026Article
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Authors and funding
4 authors.
Funding
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Abstract
backgroundSurgeries performed at night may carry higher risk due to provider fatigue and reduced staffing, but data from neurosurgical populations are limited. We evaluated whether nighttime evacuation of chronic subdural hematoma (CSDH) was associated with increased complications or recurrence.
methodsWe conducted a retrospective cohort study of adults undergoing CSDH surgery at a tertiary neurosurgical center between 2006 and 2023. The primary exposure was nighttime surgery, defined by procedure start time. Primary outcomes were moderate-to-severe complications (Landriel-Ibáñez grade II-IV within 30 days) and CSDH recurrence (reoperation within 6 months). Multivariable logistic regression was used to adjust for confounders.
resultsOf 2860 patients, 709 (25%) underwent nighttime surgery. Nighttime surgery was independently associated with an increased risk of moderate-to-severe complications (OR 1.58, 95% CI 1.04-2.37; p = 0.028). This risk peaked during the final hours of the night shift. Although CSDH recurrence was more common after nighttime surgery in unadjusted analysis (13% vs. 10%), this difference was not significant after confounder adjustment.
conclusionNighttime surgery for CSDH was associated with an increased risk of moderate-to-severe complications. When feasible, surgery should be performed during daytime hours.
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