Middle-of-the-night PCIs do not adversely affect success of next-day procedures

Sleep deprivation does not disturb interventionist performance

2012-04-02

(Press-News.org) A single-center study found that percutaneous coronary intervention (PCI) procedures performed during the middle of the night do not adversely affect the safety and effectiveness of procedures performed the next day by the same operator. Findings now available in Catheterization and Cardiovascular Interventions, a journal published by Wiley-Blackwell on behalf of The Society for Cardiovascular Angiography and Interventions (SCAI), show late night work while on call does not worsen performance of the interventionist doing PCIs the next day.

Studies have shown that sleep deprivation in medical personnel may increase the risk of serious medical errors, percutaneous injuries and motor vehicle accidents. Moreover, previous research has reported higher complication and failure rates for PCIs performed after regular working hours. However, to date no study has provided evidence of operator fatigue on the success and complication rates of PCI procedures. Each year more than one million PCI procedures, commonly known as angioplasty, are performed in the U.S. according to the National Heart, Lung, and Blood Institute.

For the present study, Vitalie Crudu, MD, and colleagues from Geisinger Medical Center in Danville, Pa., identified PCIs performed at the center from January 1, 2005 through December 31, 2009 between 11 p.m. and 7 a.m. PCIs performed during the following work day by the same interventionist were compared to PCI's performed by interventionists not on call the night before.

The team reported 3,944 PCIs were performed by four operators during the five-year period, which included 167 PCIs performed by operators after late night work while on call. The overall incidence of complications were similar in the PCIs done by operators working the night before compared with PCIs done by rested physicians. Types of complications identified as potentially more sensitive to operator error or judgement occurred with similar frequency in both groups. The post-call physician PCIs had 1.2% intra-procedural deaths compared to 0.2% in the rested physician group, a difference that was not statistically significant. Researchers reported more frequent excessive bleeding at the access site in the rested versus post-call PCIs at 2.7% and 0%, respectively.

"Our investigation found no evidence that middle-of-the-night PCIs adversely affect safety or efficacy of procedures performed the subsequent day by the same interventionist," concludes Dr. Crudu. "Further study with larger a larger number of cases is necessary to identify any warning signals of correlations between sleep deprivation and PCI outcomes." In the interim, the authors suggest that sleep-deprived interventionists could minimize risk by deferring emergency cases to rested colleagues and avoiding elective high risk PCIs while fatigued.

###This study is published in Catheterization and Cardiovascular Interventions. Media wishing to receive a PDF of the article may contact healthnews@wiley.com.

Full citation:"Middle-of-the-Night PCI Does Not Affect Subsequent Day PCI Success and Complication Rates by the Same Operator." Vitalie Crudu, Jennifer Sartorius, Peter Berger, Thomas Scott, Kimberly Skelding and James Blankenship. Catheterization and Cardiovascular Interventions; Published Online: March 30, 2012 (DOI: 10.1002/ccd.23504). Author Contact: To arrange an interview with Dr. Crudu please contact Amy Wright with Geisinger Medical Center at AMWRIGHT1@geisinger.edu.

Catheterization and Cardiovascular Interventions is the official journal of The Society for Cardiovascular Angiography and Interventions. This international journal covers the broad field of cardiovascular diseases. Subject material includes basic and clinical information that is derived from or related to invasive and interventional coronary or peripheral vascular techniques. The journal focuses on material that will be of immediate practical value to physicians providing patient care in the clinical laboratory setting. To accomplish this, the journal publishes Preliminary Reports and Work In Progress articles that complement the traditional Original Studies, Case Reports, and Comprehensive Reviews. Perspective and insight concerning controversial subjects and evolving technologies are provided regularly through Editorial Commentaries furnished by members of the Editorial Board and other experts. Articles are subject to double-blind peer review and complete editorial evaluation prior to any decision regarding acceptability. For more information, please visit http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)1522-726X.

The Society for Cardiovascular Angiography and Interventions (SCAI) is the primary professional association for invasive and interventional cardiologists, representing over 4,300 physicians in 60 countries. The Society's mission is to promote excellence in invasive and interventional cardiovascular medicine through physician education and representation, its monthly journal Catheterization and Cardiovascular Interventions, and the advancement of quality standards to enhance patient care. For more information, please visit http://www.scai.org or SCAI's comprehensive patient education website, http://www.SecondsCount.org.

Wiley-Blackwell is the international scientific, technical, medical, and scholarly publishing business of John Wiley & Sons, with strengths in every major academic and professional field and partnerships with many of the world's leading societies. Wiley-Blackwell publishes nearly 1,500 peer-reviewed journals and 1,500+ new books annually in print and online, as well as databases, major reference works and laboratory protocols. For more information, please visit http://www.wileyblackwell.com or our new online platform, Wiley Online Library (http://www.wileyonlinelibrary.com), one of the world's most extensive multidisciplinary collections of online resources, covering life, health, social and physical sciences, and humanities.

ELSE PRESS RELEASES FROM THIS DATE:

Making mice comfy leads to better science, Stanford researcher says

2012-04-02

STANFORD, Calif. — Nine out of 10 drugs successfully tested in mice and other animal models ultimately fail to work in people, and one reason may be traced back to a common fact of life for laboratory mice: they're cold, according to a researcher at the Stanford University School of Medicine. Laboratory mice, which account for the vast majority of animal research subjects, are routinely housed in chilly conditions, which may affect their well-being as well as the outcome of research studies, said Joseph Garner, PhD, associate professor of comparative medicine. "If you ...

Starvation linked to greater risk of cardiac complications

2012-04-02

London -- Russians born during the Leningrad Siege in World War II, which was responsible for some of the greatest losses of civilian life in history, are giving scientists new strategies to identify people who experienced intrauterine growth restriction (IUGR) and starvation during childhood at greatest risk of developing long term heart complications. The abstract study¹, presented at the Frontiers in CardioVascular Biology (FCVB) meeting, in London, UK, 30 March to 1 April 2012, makes use of a unique population of people exposed to extreme starvation both as foetuses ...

Clocking an accelerating universe: First results from BOSS

2012-04-02

Some six billion light years ago, almost halfway from now back to the big bang, the universe was undergoing an elemental change. Held back until then by the mutual gravitational attraction of all the matter it contained, the universe had been expanding ever more slowly. Then, as matter spread out and its density decreased, dark energy took over and expansion began to accelerate. Today BOSS, the Baryon Oscillation Spectroscopic Survey, the largest component of the third Sloan Digital Sky Survey (SDSS-III), announced the most accurate measurement yet of the distance scale ...

Benefits of taking Fido to work may not be far 'fetched'

2012-04-02

RICHMOND, Va. (March 30, 2012) – Man's best friend may make a positive difference in the workplace by reducing stress and making the job more satisfying for other employees, according to a Virginia Commonwealth University study. Stress is a major contributor to employee absenteeism, morale and burnout and results in significant loss of productivity and resources. But a preliminary study, published in the March issue of the International Journal of Workplace Health Management, found that dogs in the workplace may buffer the impact of stress during the workday for their ...

Volcanic plumbing exposed

2012-04-02

Two new studies into the "plumbing systems" that lie under volcanoes could bring scientists closer to predicting large eruptions. International teams of researchers, led by the University of Leeds, studied the location and behaviour of magma chambers on the Earth's mid-ocean ridge system - a vast chain of volcanoes along which the Earth forms new crust. They worked in Afar (Ethiopia) and Iceland - the only places where mid-ocean ridges appear above sea level. Volcanic ridges (or "spreading centres") occur when tectonic plates "rift" or pull apart. Magma (hot molten ...

Some corals like it hot: Heat stress may help coral reefs survive climate change

2012-04-02

A team of international scientists working in the central Pacific have discovered that coral which has survived heat stress in the past is more likely to survive it in the future. The study, published today in the journal PLoS ONE, paves the way towards an important road map on the impacts of ocean warming, and will help scientists identify the habitats and locations where coral reefs are more likely to adapt to climate change. "We're starting to identify the types of reef environments where corals are more likely to persist in the future," says study co-author Simon ...

The electronic nose knows when your cantaloupe is ripe

2012-04-02

Have you ever been disappointed by a cantaloupe from the grocery store? Too ripe? Not ripe enough? Luckily for you, researchers from the University of California, Davis might have found a way to make imperfectly ripe fruit a thing of the past. The method will be published on March 30 in the Journal of Visualized Experiments (JoVE). "We are involved in a project geared towards developing rapid methods to evaluate ripeness and flavour of fruits," said paper-author Dr. Florence Negre-Zkharov. "We evaluated an electronic nose to see if it can differentiate maturity of fruit, ...

The link between fast food and depression has been confirmed

2012-04-02

According to a recent study headed by scientists from the University of Las Palmas de Gran Canaria and the University of Granada, eating commercial baked goods (fairy cakes, croissants, doughnuts, etc.) and fast food (hamburgers, hotdogs and pizza) is linked to depression. Published in the Public Health Nutrition journal, the results reveal that consumers of fast food, compared to those who eat little or none, are 51% more likely to develop depression. Furthermore, a dose-response relationship was observed. In other words this means that "the more fast food you consume, ...

ADHD is over-diagnosed

2012-04-02

What experts and the public have already long suspected is now supported by representative data collected by researchers at Ruhr-Universität Bochum (RUB) and University of Basel: ADHD, attention deficit hyperactivity disorder, is over-diagnosed. The study showed that child and adolescent psychotherapists and psychiatrists tend to give a diagnosis based on heuristics, unclear rules of thumb, rather than adhering to recognized diagnostic criteria. Boys in particular are substantially more often misdiagnosed compared to girls. These are the most important results of a study ...

Whether grasping Easter eggs or glass bottles – this robotic hand uses tact

2012-04-02

It may be difficult to imagine, but pouring juice into a plastic cup can be a great challenge to a robot. While one hand holds the glass bottle firmly, the other one must gently grasp the cup. Researchers at Saarland University together with associates in Bologna and Naples have developed a robotic hand that can accomplish both tasks with ease and yet including the actuators is scarcely larger than a human arm. This was made possible by a novel string actuator, making use of small electric motors to twist strings. The robotic hand is thus powerful yet delicate and could ...

Middle-of-the-night PCIs do not adversely affect success of next-day procedures

ELSE PRESS RELEASES FROM THIS DATE:

LAST 30 PRESS RELEASES: