{"doi":"10.1016/j.xjon.2024.04.018","title":"Outcomes of nonemergency cardiac surgery after overnight operative workload: A statewide experience","abstract":"<h2>Abstract</h2><h3>Objective</h3> Cardiac surgeons experience unpredictable overnight operative responsibilities, with variable rest before same-day, first-start scheduled cases. This study evaluated the frequency and associated impact of a surgeon's overnight operative workload on the outcomes of their same-day, first-start operations. <h3>Methods</h3> A statewide cardiac surgery quality database was queried for adult cardiac surgical operations between July 1, 2011, and March 1, 2021. Nonemergency, first-start, Society of Thoracic Surgeons predicted risk of mortality operations were stratified by whether or not the surgeon performed an overnight operation that ended after midnight. A generalized mixed effect model was used to evaluate the effect of overnight operations on a Society of Thoracic Surgeons composite outcome (5 major morbidities or operative mortality) of the first-start operation. <h3>Results</h3> Of all first-start operations, 0.4% (239/56,272) had a preceding operation ending after midnight. The Society of Thoracic Surgeons predicted risk of morbidity and mortality was similar for first-start operations whether preceded by an overnight operation or not (overnight operation: 11.3%; no overnight operation: 11.7%, <i>P</i> = .42). Unadjusted rates of the primary outcome were not significantly different after an overnight operation (overnight operation: 13.4%; no overnight operation: 12.3%, <i>P</i> = .59). After adjustment, overnight operations did not significantly impact the risk of major morbidity or mortality for first-start operations (adjusted odds ratio, 1.1, <i>P</i> = .70). <h3>Conclusions</h3> First-start cardiac operations performed after an overnight operation represent a small subset of all first-start Society of Thoracic Surgeons predicted risk operations. Overnight operations do not significantly influence the risk of major morbidity or mortality of first-start operations, which suggests that surgeons exercise proper judgment in determining appropriate workloads.","journal":"JTCVS Open","year":2024,"id":498007,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8184,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":722069,"name":"Michael J. Pienta","orcid":"0000-0002-8174-0240","position":1,"is_corresponding":false},{"id":385417,"name":"Xiaoting Wu","orcid":"0000-0001-8011-9324","position":2,"is_corresponding":false},{"id":502855,"name":"Michael P. Thompson","orcid":"0000-0002-9992-593X","position":3,"is_corresponding":false},{"id":334948,"name":"Robert B. Hawkins","orcid":"0000-0002-3959-8201","position":4,"is_corresponding":false},{"id":1037334,"name":"Andrew L. Pruitt","orcid":null,"position":5,"is_corresponding":false},{"id":503871,"name":"Alphonse DeLucia","orcid":null,"position":6,"is_corresponding":false},{"id":493288,"name":"Shelly C. Lall","orcid":null,"position":7,"is_corresponding":false},{"id":495788,"name":"Francis D. Pagani","orcid":"0000-0003-4430-9969","position":8,"is_corresponding":false},{"id":492619,"name":"Donald S. Likosky","orcid":"0000-0003-0416-9359","position":9,"is_corresponding":false},{"id":228249,"name":"Tyler M. Bauer","orcid":"0000-0002-5430-5104","position":0,"is_corresponding":true}],"reference_count":20,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T02:09:38.543544Z","pmid":"39296458","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}