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Cardiovascular daytime varying effect in cardiac surgery on surgical site infections and 1-year mortality: A prospective cohort study with 22,305 patients

  • Rami Sommerstein (a1), Jonas Marschall (a1) (a2), Stefan P. Kuster (a2) (a3), Nicolas Troillet (a2) (a4), Thierry Carrel (a5), Friedrich S. Eckstein (a6), Andreas F. Widmer (a2) (a7) and Swissnoso (a8)...


Afternoon aortic valve replacement surgery may provide perioperative myocardial protection and improve patient outcomes compared with morning surgery. The results of our large observational study based on Swiss cardiac surgical site infection surveillance data suggest that the current evidence is insufficient to generally promote afternoon cardiac surgeries.


Corresponding author

Author for correspondence: Rami Sommerstein, MD, Department of Infectious Diseases, Bern University Hospital, University of Bern, Freiburgstrasse, 3010 Bern, Switzerland. E-mail: Or Andreas F. Widmer, MD, Department of Infectious Diseases, University Hospital Basel, Spitalstrasse 21/Petersgraben 4, Basel, 4031 Switzerland. E-mail:


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PREVIOUS PRESENTATION: A previous version (poster) was presented at IDWeek 2018 on October 6, 2018, in San Francisco, California.



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1. Ammirati, E, Cristell, N, Cianflone, D, et al. Questing for circadian dependence in ST-segment-elevation acute myocardial infarction: a multicentric and multiethnic study. Circ Res 2013;112:e110e114.
2. Montaigne, D, Marechal, X, Modine, T, et al. Daytime variation of perioperative myocardial injury in cardiac surgery and its prevention by Rev-Erbα antagonism: a single-centre propensity-matched cohort study and a randomised study. Lancet 2018;6;391(10115):5969.
3. Troillet, N, Aghayev, E, Eisenring, MC, Widmer, AF, Swissnoso. First results of the Swiss National Surgical Site Infection Surveillance Program: who seeks shall find. Infect Control Hosp Epidemiol 2017;38:697704.
4. Kuster, SP, Eisenring, MC, Sax, H, Troillet, N, Swissnoso. Structure, process, and outcome quality of surgical site infection surveillance in Switzerland. Infect Control Hosp Epidemiol 2017;38:11721181.
5. Frieden, TR. Evidence for health decision making—beyond randomized, controlled trials. N Engl J Med 2017;377:465475.
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Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
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