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. 2021 Sep;31(5):629-637.
doi: 10.1111/vec.13066. Epub 2021 Jul 30.

Associations between surgical start time (regular vs after hours) and morbidity and mortality during hospitalization in dogs and cats

Marina J McConkey  1 , Eric T Alexopoulos  1 , Jorge A Hernandez  1   2
Affiliations

Associations between surgical start time (regular vs after hours) and morbidity and mortality during hospitalization in dogs and cats

Marina J McConkey et al. J Vet Emerg Crit Care (San Antonio). 2021 Sep.

Abstract

Objective: To examine the relationship between after-hours (ie, nights and weekends) emergency general surgery and morbidity or mortality in dogs and cats during hospitalization.

Design: Cross-sectional study from September 1, 2013 to May 31, 2017.

Setting: University teaching hospital.

Animals: Four hundred seventy-four dogs and 66 cats that underwent emergency general surgery (gastrointestinal, hepatobiliary, urogenital, soft tissue traumatic injury, splenectomy/excision of bleeding abdominal tumor, surgical revision, and negative exploratory categories) with the emergency surgery service. All patients were required to have complete medical records.

Interventions: None.

Measurements and main results: Study animals were grouped as exposed or not exposed to after-hours emergency surgery. They were further classified as either postoperatively dead or suffering morbidity (yes or no). Additional exposure factors (eg, age, sex, American Society of Anesthesiology [ASA] status) were investigated. Multivariable logistic regression was used to identify and quantify any associations with mortality or morbidity. In dogs, exposure to after-hours emergency general surgery was not associated with mortality or morbidity. In dogs, both mortality and morbidity were associated with ASA status. In cats, mortality was not examined because the number of dead cats was small (n = 5). The odds of morbidity were 3.4 times lower (1/0.29) in cats having emergency surgery after hours, compared to cats admitted during regular hours (odds ratio [OR], 0.29; 95% Confidence Interval (CI), 0.09-0.93; P = 0.03). No other investigated exposure factors were associated with morbidity in study cats.

Conclusions: After-hours emergency surgery in dogs was not associated with increased risk of mortality and morbidity at the study facility. Feline patients having emergency surgery during regular hospital hours had a higher risk of morbidity; further investigation of modifiable risk factors is warranted.

Keywords: emergency surgery; feline; morbidity; trauma.

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References

REFERENCES

    1. Bell CM, Redelmeier DA. Mortality among patients admitted to hospitals on weekends as compared with weekdays. New Engl J Med. 2001;345:663-668.
    1. Cavallazzi R, Marik PE, Hirani A, Pachinburavan M, Vasu TS, Leiby BE. Association between time of admission to the ICU and mortality: a systematic review and metaanalysis. Chest. 2010;138:68-75.
    1. Ogbu UC, Westert GP, Slobbe LCJ, Stronks K, Arah OA. A multifaceted look at time of admission and its impact on case-fatality among a cohort of ischaemic stroke patients. J Neurol Neurosurg Psychiatr. 2011;82:8-13.
    1. Arias Y, Taylor DS, Marcin JP. Association between evening admissions and higher mortality rates in the pediatric intensive care unit. Pediatrics. 2004;113:e530-e534.
    1. Lapointe-Shaw L, Abushomar H, Chen XK, et al. Care and outcomes of patients with cancer admitted to the hospital on weekends and holidays: a retrospective cohort study. J Natl Compr Cancer Netw. 2016;14:867-874.

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