Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, Minneapolis, Minnesota.
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.
Catheter Cardiovasc Interv. 2018 Nov 15;92(6):1118-1125. doi: 10.1002/ccd.27471. Epub 2018 Jan 3.
This study sought to compare the clinical outcomes of percutaneous coronary interventions (PCIs) performed by sleep deprived and non-sleep deprived operators.
Interventional cardiologists are at risk for sleep deprivation as they often have to perform emergent procedures at night, but the effects of sleep deprivation on clinical outcomes have received limited study.
We examined the frequency, clinical characteristics, and outcomes of daytime PCIs performed by sleep deprived and non-sleep deprived operators at a tertiary medical center. Operators were considered sleep deprived when performing a daytime (7 am-11:59 pm) procedure preceded by a nighttime (12 am-6:59 am) procedure on the same date.
Of the 12,680 daytime PCIs performed from 6/29/09 to 12/30/2016, 367 (2.9%) were performed by sleep deprived operators. Patients undergoing PCI performed by a sleep deprived operator were more likely to be younger, white, and to present with ST-elevation acute myocardial infarction (STEMI). The incidence of in-hospital death (1.1% vs. 1.3%, P = 1.0) and bleeding within 72 hr (3.9% vs. 2.9%, P = 0.29) were similar for procedures performed by sleep-deprived and non-sleep deprived operators. When the sleep deprived group was further stratified based on degree of sleep deprivation or length of sleep interruption, differences in mortality and total bleeding remained non-significant.
In this large single center study, operator sleep deprivation did not appear to adversely impact PCI outcomes.
本研究旨在比较睡眠不足和非睡眠不足操作者行经皮冠状动脉介入治疗(PCI)的临床结局。
介入心脏病学家存在睡眠不足的风险,因为他们经常需要在夜间进行紧急手术,但睡眠不足对临床结局的影响尚未得到充分研究。
我们研究了一家三级医疗中心中睡眠不足和非睡眠不足操作者行日间 PCI 的频率、临床特征和结局。当操作者在同一天行日间(7:00 am-11:59 pm)程序,且前序为夜间(12:00 am-6:59 am)程序时,认为该操作者处于睡眠不足状态。
在 2009 年 6 月 29 日至 2016 年 12 月 30 日期间进行的 12680 例日间 PCI 中,有 367 例(2.9%)由睡眠不足的操作者进行。与由非睡眠不足操作者进行的 PCI 相比,由睡眠不足操作者进行的 PCI 的患者更年轻、更白,且更可能出现 ST 段抬高型急性心肌梗死(STEMI)。住院期间死亡率(1.1%比 1.3%,P=1.0)和 72 小时内出血(3.9%比 2.9%,P=0.29)的发生率在睡眠剥夺组和非睡眠剥夺组之间相似。当根据睡眠剥夺程度或睡眠中断时间进一步对睡眠剥夺组进行分层时,死亡率和总出血率的差异仍然无统计学意义。
在这项大型单中心研究中,操作者睡眠不足似乎不会对 PCI 结局产生不利影响。