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 firstname.lastname@example.org.
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.
Deep Brain Stimulation Provides Sustained Relief for Severe Depression
19.03.2019 | Universitätsklinikum Freiburg
AI study of risk factors in type 1 diabetes
06.03.2019 | University of Gothenburg
DESY and MPSD scientists create high-order harmonics from solids with controlled polarization states, taking advantage of both crystal symmetry and attosecond electronic dynamics. The newly demonstrated technique might find intriguing applications in petahertz electronics and for spectroscopic studies of novel quantum materials.
The nonlinear process of high-order harmonic generation (HHG) in gases is one of the cornerstones of attosecond science (an attosecond is a billionth of a...
Nano- and microtechnology are promising candidates not only for medical applications such as drug delivery but also for the creation of little robots or flexible integrated sensors. Scientists from the Max Planck Institute for Polymer Research (MPI-P) have created magnetic microparticles, with a newly developed method, that could pave the way for building micro-motors or guiding drugs in the human body to a target, like a tumor. The preparation of such structures as well as their remote-control can be regulated using magnetic fields and therefore can find application in an array of domains.
The magnetic properties of a material control how this material responds to the presence of a magnetic field. Iron oxide is the main component of rust but also...
Due to the special arrangement of its molecules, a new coating made of corn starch is able to repair small scratches by itself through heat: The cross-linking via ring-shaped molecules makes the material mobile, so that it compensates for the scratches and these disappear again.
Superficial micro-scratches on the car body or on other high-gloss surfaces are harmless, but annoying. Especially in the luxury segment such surfaces are...
The Potsdam Echelle Polarimetric and Spectroscopic Instrument (PEPSI) at the Large Binocular Telescope (LBT) in Arizona released its first image of the surface magnetic field of another star. In a paper in the European journal Astronomy & Astrophysics, the PEPSI team presents a Zeeman- Doppler-Image of the surface of the magnetically active star II Pegasi.
A special technique allows astronomers to resolve the surfaces of faraway stars. Those are otherwise only seen as point sources, even in the largest telescopes...
Researchers at Chalmers University of Technology and the University of Gothenburg, Sweden, have proposed a way to create a completely new source of radiation. Ultra-intense light pulses consist of the motion of a single wave and can be described as a tsunami of light. The strong wave can be used to study interactions between matter and light in a unique way. Their research is now published in the scientific journal Physical Review Letters.
"This source of radiation lets us look at reality through a new angle - it is like twisting a mirror and discovering something completely different," says...
11.03.2019 | Event News
01.03.2019 | Event News
28.02.2019 | Event News
22.03.2019 | Life Sciences
22.03.2019 | Life Sciences
22.03.2019 | Information Technology