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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Neurosurgery
2018 ; 82
(3
): 329-334
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Outcomes of Elective Cerebral Aneurysm Treatment Performed by Attending
Neurosurgeons after Night Work
#MMPMID28575518
Bekelis K
; Missios S
; MacKenzie TA
Neurosurgery
2018[Mar]; 82
(3
): 329-334
PMID28575518
show ga
BACKGROUND: The association between long work hours and outcomes among attending
surgeons remains an issue of debate. OBJECTIVE: To investigate whether operating
emergently the night before an elective case was associated with inferior
outcomes among attending neurosurgeons. METHODS: We executed a cohort study with
unruptured cerebral aneurysm patients, who underwent endovascular coiling or
surgical clipping from 2009 to 2013 and were registered in the Statewide Planning
and Research Cooperative System database. We investigated the association of
treatment by surgeons performing emergency procedures the night before with
outcomes of elective cerebral aneurysm treatment using an instrumental variable
analysis. RESULTS: Overall, 4700 patients underwent treatment for unruptured
cerebral aneurysms. There was no difference in inpatient mortality (adjusted
difference, -0.7%; 95% confidence interval [CI], -1.4% to 0.02%), discharge to a
facility (adjusted difference, -0.1%; 95% CI, -1.2% to 1.2%), or length of stay
(adjusted difference, -0.58; 95% CI, -1.66 to 0.50) between patients undergoing
elective cerebral aneurysm treatment by surgeons who performed emergency
procedures the night before, and those who did not. CONCLUSION: Using a
comprehensive patient cohort in New York State for elective treatment of
unruptured cerebral aneurysms, we did not identify an association of treatment by
surgeons performing emergency procedures the night before, with mortality,
discharge to a facility, or length of stay. Our study had 80% power to detect
differences in mortality (our primary outcome), as small as 4.1%. The results of
the present study do not support the argument for regulation of attending work
hours.