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THE JOURNAL OF CARDIOVASCULAR SURGERY

A Journal on Cardiac, Vascular and Thoracic Surgery


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The Journal of Cardiovascular Surgery 2017 Nov 16

DOI: 10.23736/S0021-9509.17.10056-X

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Meta-analysis of day-of-week variation of acute aortic rupture or dissection

Hisato TAKAGI 1 , Tomo ANDO 2, Shohei MITTA 1, Takuya UMEMOTO 1, For the ALICE Group 

1 Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan; 2 Department of Cardiology, Detroit Medical Center, Detroit, MI, USA


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BACKGROUND: We performed a meta-analysis to assess the presence of a day-of-week rhythmic variability of acute aortic rupture or dissection (AARD) onset.
METHODS: Eligible studies were observational studies enrolling patients with AARD and reporting day-of-week variation of AARD. Study-specific estimates, i.e. day-of-week incidence of AARD, were combined using the random-effects model. Chronobiological analysis was performed by applying a partial Fourier series to pooled day-of-week incidence by using the inverse-variance weighted least-squares method.
RESULTS: We identified 9 eligible studies enrolling a total of 28,036 patients with AARD. Pooled incidence of AARD was 12.8% on Sunday, 15.9% on Monday, 14.8% on Tuesday, 15.1% on Wednesday, 14.7% on Thursday, 14.1% on Friday, and 12.1% on Saturday. Chronobiological analysis identified a significant (P = 0.0098) day-of-week in the occurrence of AARD with a peak on Monday and a nadir on Saturday. Pooled analysis demonstrated significantly more incidence on Monday than on Saturday (relative risk, 1.247; 95% confidence interval, 1.131 to 1.374; P = 0.012).
CONCLUSIONS: Incidence of AARD was 12.8%, 15.9%, 14.8%, 15.1%, 14.7%, 14.1%, and 12.1%, on Sunday, Monday, Tuesday, Wednesday, Thursday, Friday, and Saturday, respectively. A significant day-of-week pattern in the occurrence of AARD with a peak on Monday and a nadir on Saturday was identified with significantly more incidence on Monday than on Saturday.


KEY WORDS: Acute aortic rupture or dissection - Day-of-week variation - Meta-analysis

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Publication History

Article first published online: November 16, 2017
Manuscript accepted: November 8, 2017
Manuscript revised: September 15, 2017
Manuscript received: May 31, 2017

Cite this article as

Takagi H, Ando T, Mitta S, Umemoto T; the ALICE Group. Meta-analysis of day-of-week variation of acute aortic rupture or dissection. J Cardiovasc Surg 2017 Nov 16. DOI: 10.23736/S0021-9509.17.10056-X

For the ALICE Group

Corresponding author e-mail

kfgth973@ybb.ne.jp