PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

Study finds nighttime organ transplant surgery not associated with poorer survival after 1 year

2011-06-01
(Press-News.org) An analysis of data on heart and lung transplant recipients indicates that patients who had transplant surgery performed at nighttime did not have a significantly different rate of survival up to one year after organ transplantation, according to a study in the June 1 issue of JAMA.

"Since the Institute of Medicine published a report suggesting that medical errors result in more than 98,000 deaths annually, increasing emphasis is being placed on systems-based approaches to improve patient safety," according to background information in the article. "Although the causes of medical errors are likely multifactorial, many have suggested that medical staff fatigue associated with delivering medical care outside of daytime working hours is an important driving factor. Nighttime medical care has previously been associated with worse outcomes in general medicine, cardiology, general surgery, and abdominal organ transplant surgery."

Timothy J. George, M.D., of Johns Hopkins Medical Institutions, Baltimore, and colleagues assessed whether performing heart or lung transplants at night was associated with adverse outcomes for transplant recipients. The study included information from the United Network for Organ Sharing database from January 2000 through June 2010. Primary stratification was by operative time of day (night, 7 p.m. - 7 a.m.; day, 7 a.m. - 7 p.m.). A total of 27,118 patients were included in the study population.

Of the 16,573 patients who underwent a heart transplant, 8,346 (50.4 percent) did so during the day and 8,227 (49.6 percent) during the night. Of the 10,545 patients who underwent a lung transplant, 5,179 (49.1 percent) did so during the day and 5,366 (50.9 percent) during the night. During a median (midpoint) follow-up of 32.2 months, 8,061 patients (29 percent) died. The researchers found that survival was similar for patients with organ transplants performed during the day and night.

"Survival rates at 30 days for heart transplants during the day were 95.0 percent vs. 95.2 percent during the night and for lung transplants during the day were 96.0 percent vs. 95.5 percent during the night. At 90 days, survival rates for heart transplants were 92.6 percent during the day vs. 92.7 percent during the night and for lung transplants during the day were 92.7 percent vs. 91.7 percent during the night. At 1 year, survival rates for heart transplants during the day were 88.0 percent vs. 87.7 percent during the night and for lung transplants during the day were 83.8 percent vs. 82.6 percent during the night," the authors write.

Among lung transplant recipients, there was a slightly higher rate of airway dehiscence (a surgical complication) associated with nighttime transplants. Total hospital length of stay was similar regardless of operative time of day.

"Given the emerging consensus in the literature that nighttime operations are associated with an increase in complications, it is noteworthy that operative time of day is not associated with thoracic organ transplantation outcomes in a clinically meaningful way," the authors write. "It is likely that because urgent nighttime operations are common in all types of transplant surgery, health care personnel involved in the transplant have developed various systems to prevent errors and directly cope with the limitations associated with nighttime medical care."

The researchers note that these equivalent results for thoracic organ transplants regardless of operative time of day should be taken in context. "Although our study was retrospective, it does suggest that not all trends in patient safety can be applied empirically across all specialties and that not all purportedly beneficial safety interventions are necessary or will be effective. Further investigation is warranted to understand why thoracic organ transplants do not appear to be associated with deleterious outcomes previously reported to be associated with nighttime surgery. Insight into the systems-based interventions that mitigate the effects of fatigue and disrupted circadian rhythms may provide information to help ameliorate the adverse outcomes associated with nighttime medical care in other settings."

###

(JAMA. 2011;305[21]2193-2199. Available pre-embargo to the media at www.jamamedia.org)

Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

To contact corresponding author Ashish S. Shah, M.D., call Stephanie Desmon at 410-955-8665 or email sdesmon1@jhmi.edu.

END



ELSE PRESS RELEASES FROM THIS DATE:

Fracture prediction methods may be useful for patients with diabetes

2011-06-01
Use of established fracture prediction methods in older patients with type 2 diabetes mellitus (DM) found that scores from these methods were associated with hip and nonspine fracture risk, and a certain score associated with higher risk of fracture compared to persons without DM, according to a study in the June 1 issue of JAMA. Because patients with type 2 DM often have higher levels of bone mineral density (BMD), it has been uncertain the applicability of fracture risk screening methods typically used for patients with lower levels of BMD. "It is increasingly recognized ...

Highly cited studies on biomarkers often report larger effect size estimates than subsequent studies

2011-06-01
Frequently cited studies involving associations of biomarkers report effect sizes that are often larger when compared to summary estimates from meta-analyses evaluating the same associations, according to a study in the June 1 issue of JAMA. "Many new biomarkers are continuously proposed as potential determinants of disease risk, prognosis, or response to treatment. The plethora of statistically significant associations increases expectations for improvements in risk appraisal. However, many markers get evaluated only in 1 or a few studies. Among those evaluated more ...

Nighttime surgery not a factor in survival for heart and lung transplants

2011-06-01
Despite concerns that surgeon fatigue is leading to dangerous complications for patients and data showing worse outcomes for many patients who undergo surgery at night, new Johns Hopkins research suggests that — in the case of heart and lung transplants — time of day has no affect on patient survival. "We aren't suggesting that fatigue is good," says Ashish S. Shah, an assistant professor of surgery at the Johns Hopkins University School of Medicine and the study's lead author. "But what is important is that, at least in this specialty, it seems we're able to deal with ...

WSO2 Summer School Features Free Class on Identity Management in the Cloud

WSO2 Summer School Features Free Class on Identity Management in the Cloud
2011-06-01
A cloud-based environment offers convenient and cost-effective access to technology. However, it also increases the security risk and need for appropriate authentication and authorization processes--particularly as enterprise information extends from in-house systems to popular software-as-a-Service (SaaS) offerings, such Salesforce.com and Google Apps. A cloud-based approach to centralized identity management provides a robust alternative to server-based solutions for enabling secure access to diverse applications, whether on-premise or running as SaaS. IT architects ...

People with mental illness have higher mortality after heart attacks but receive inferior care

2011-06-01
New research from the University of Leicester raises concerns about higher than expected mortality following acute coronary events such as heart attack in those with significant mental ill health. Researchers from the University of Leicester in the UK and Curtin Health Innovation Research Institute in Australia examined 22 previous studies involving 825,754 individuals, comparing care given to those with and without serious mental disorders. They discovered that there was higher than expected mortality following acute coronary events such as heart attack in those ...

Ocean acidification leaves clownfish deaf to predators

2011-06-01
Since the Industrial Revolution, over half of all the CO2 produced by burning fossil fuels has been absorbed by the ocean, making pH drop faster than any time in the last 650,000 years and resulting in ocean acidification. Recent studies have shown that this causes fish to lose their sense of smell, but a new study published today in Biology Letters shows that fish hearing is also compromised. Working with Professor Philip Munday at James Cook University, lead author Dr Steve Simpson of the School of Biological Sciences at the University of Bristol reared larvae straight ...

UCI researchers find link between environment and genetics in triggering MS

2011-06-01
Irvine, Calif. — Environmental and inherited risk factors associated with multiple sclerosis – previously poorly understood and not known to be connected – converge to alter a critical cellular function linked to the chronic neurologic disease, researchers with the UC Irvine Multiple Sclerosis Research Center have discovered. The findings, which appear in the online, open-access journal Nature Communications, suggest that a unifying mechanism may be responsible for multiple sclerosis and point to therapies personalized according to genetic factors. "MS results from ...

Steady relationships reduce amphetamine's rewarding effects

2011-06-01
Long-term relationships make the commonly abused drug amphetamine less appealing, according to a new animal study in the June 1 issue of The Journal of Neuroscience. The findings suggest that social bonds formed during adulthood lead to changes in the brain that may protect against drug abuse. Prairie voles are rodents that form lifelong bonds with mating partners. In the new study, researchers directed by Zuoxin Wang, PhD, of Florida State University, found that male voles in established relationships displayed less interest ...

Association between biomarkers and disease often overstated, Stanford researcher finds

2011-06-01
STANFORD, Calif. — More than two dozen widely cited studies linking genes or other "biomarkers" to specific diseases vastly overstate the association, according to new research from an expert in scientific study design at the Stanford University School of Medicine. As a result, clinicians may be making decisions for their patients based on inaccurate conclusions not supported by other, larger studies. The widely cited studies include one linking the BRCA1 mutation with colon cancer, another that links levels of C-reactive protein in the blood with cardiovascular disease ...

Nanoscale waveguide for future photonics

Nanoscale waveguide for future photonics
2011-06-01
The creation of a new quasiparticle called the "hybrid plasmon polariton" may throw open the doors to integrated photonic circuits and optical computing for the 21st century. Researchers with the U.S. Department of Energy (DOE)'s Lawrence Berkeley National Laboratory (Berkeley Lab) have demonstrated the first true nanoscale waveguides for next generation on-chip optical communication systems. "We have directly demonstrated the nanoscale waveguiding of light at visible and near infrared frequencies in a metal-insulator-semiconductor device featuring low loss and broadband ...

LAST 30 PRESS RELEASES:

Thirty-year mystery of dissonance in the “ringing” of black holes explained

Less intensive works best for agricultural soil

Arctic rivers project receives “national champion” designation from frontiers foundation

Computational biology paves the way for new ALS tests

Study offers new hope for babies born with opioid withdrawal syndrome

UT, Volkswagen Group of America celebrate research partnership

New Medicare program could dramatically improve affordability for cancer drugs – if patients enroll

Are ‘zombie’ skin cells harmful or helpful? The answer may be in their shapes

University of Cincinnati Cancer Center presents research at AACR 2025

Head and neck, breast, lung and survivorship studies headline Dana-Farber research at AACR Annual Meeting 2025

AACR: Researchers share promising results from MD Anderson clinical trials

New research explains why our waistlines expand in middle age

Advancements in muon detection: Taishan Antineutrino Observatory's innovative top veto tracker

Chips off the old block

Microvascular decompression combined with nerve combing for atypical trigeminal neuralgia

Cutting the complexity from digital carpentry

Lung immune cell type “quietly” controls inflammation in COVID-19

Fiscal impact of expanded Medicare coverage for GLP-1 receptor agonists to treat obesity

State and sociodemographic trends in US cigarette smoking with future projections

Young adults drive historic decline in smoking

NFCR congratulates Dr. Robert C. Bast, Jr. on receiving the AACR-Daniel D. Von Hoff Award for Outstanding Contributions to Education and Training in Cancer Research

Chimpanzee stem cells offer new insights into early embryonic development

This injected protein-like polymer helps tissues heal after a heart attack

FlexTech inaugural issue launches, pioneering interdisciplinary innovation in flexible technology

In Down syndrome mice, 40Hz light and sound improve cognition, neurogenesis, connectivity

Methyl eugenol: potential to inhibit oxidative stress, address related diseases, and its toxicological effects

A vascularized multilayer chip reveals shear stress-induced angiogenesis in diverse fluid conditions

AI helps unravel a cause of Alzheimer's disease and identify a therapeutic candidate

Coalition of Autism Scientists critiques US Department of Health and Human Services Autism Research Initiative

Structure dictates effectiveness, safety in nanomedicine

[Press-News.org] Study finds nighttime organ transplant surgery not associated with poorer survival after 1 year