{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T10:39:46Z","timestamp":1788172786121,"version":"build-2803163510"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T00:00:00Z","timestamp":1758499200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["RS\u20102022\u201000165755"],"award-info":[{"award-number":["RS\u20102022\u201000165755"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>There is limited knowledge regarding the impact of surgical start time on postoperative outcomes in elective non\u2010cardiac surgery. This study investigated the association between surgical start time and surgical outcomes in elective non\u2010cardiac surgeries, including mortality; morbidity; and healthcare utilisation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analysed 291,051 patients who underwent non\u2010cardiac surgery. Patients were grouped by surgical start time: morning (08:00\u201313:00) vs. afternoon (13:00\u201318:00). Restricted mean survival time was calculated to assess survival differences. Outcomes were also stratified by weekday and season. Subgroup analyses evaluated associations between surgical timing and outcomes in high\u2010risk populations, including older adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After propensity score matching, statistically significant differences were observed between the morning and afternoon groups for 30\u2010day mortality (0.12% vs. 0.17%, p\u2009=\u20090.015); 1\u2010year mortality (2.73% vs. 3.36%, p\u2009&lt;\u20090.001); composite complications (5.48% vs. 5.94%, p\u2009=\u20090.003); ICU admissions (5.87% vs. 7.18%, p\u2009&lt;\u20090.001); and intra\u2010operative transfusions (3.40% vs. 4.10%, p\u2009&lt;\u20090.001). Restricted mean survival time analysis revealed significantly shorter survival times in the afternoon group across all time points. Afternoon surgery was associated with increased risk of 30\u2010day mortality (adjusted hazard ratio 1.33, 95%CI 1.07\u20131.66, p\u2009=\u20090.010); 1\u2010year mortality (adjusted hazard ratio 1.26, 95%CI 1.20\u20131.32, p\u2009&lt;\u20090.001); composite complications (adjusted odds ratio 1.05, 95%CI 1.01\u20131.08, p\u2009=\u20090.010); ICU admission (adjusted odds ratio 1.09, 95%CI: 1.06\u20131.13, p\u2009&lt;\u20090.001); and intra\u2010operative transfusions (adjusted odds ratio 1.27, 95%CI 1.21\u20131.33, p\u2009&lt;\u20090.001). Subgroup analysis indicated that the impact of surgical start time on outcomes was more pronounced in high\u2010risk patients and also varied significantly depending on the type of surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Surgical start timing was an independent risk factor for increased short\u2010 and long\u2010term postoperative mortality, morbidity and healthcare resource utilisation. The reasons for this are likely to be multifactorial.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/anae.16788","type":"journal-article","created":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T03:26:28Z","timestamp":1758597988000},"page":"72-82","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Association between surgical start time and postoperative mortality, morbidity and healthcare utilisation in elective non\u2010cardiac surgeries: a retrospective, single\u2010centre study using propensity score matching"],"prefix":"10.1111","volume":"81","author":[{"given":"Ji\u2010Hoon","family":"Sim","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine Asan Medical Center, University of Ulsan College of Medicine  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bumwoo","family":"Park","sequence":"additional","affiliation":[{"name":"Big Data Research Center Asan Medical Center  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeseul","family":"Choi","sequence":"additional","affiliation":[{"name":"Division of Artificial Intelligence and Software Ewha Womans University  Seoul South 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