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Abstract
Previous studies have demonstrated that environmental and temporal factors may affect the incidence of acute type A aortic dissection (ATAAD). Here, we aimed to investigate the hypothesis that national holidays and weekends influence the incidence of surgery for ATAAD. For the period 1st of January 2005 until 31st of December 2019, we investigated a hypothesised effect of (country-specific) national holidays and weekends on the frequency of 2995 surgical repairs for ATAAD at 10 Nordic cities included in the Nordic Consortium for Acute Type A Aortic Dissection (NORCAAD) collaboration. Compared to other days, the number of ATAAD repairs were 29% (RR 0.71; 95% CI 0.54–0.94) lower on national holidays and 26% (RR 0.74; 95% CI 0.68–0.82) lower on weekends. As day of week patterns of symptom duration were assessed and the primary analyses were adjusted for period of year, our findings suggest that the reduced surgical incidence on national holidays and weekends does not seem to correspond to seasonal effects or surgery being delayed and performed on regular working days.
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1 Lund University, Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund, Sweden (GRID:grid.4514.4) (ISNI:0000 0001 0930 2361); Umeå University, Division of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå, Sweden (GRID:grid.12650.30) (ISNI:0000 0001 1034 3451)
2 Lund University, Department of Cardiothoracic Surgery, Skåne University Hospital, Lund, Sweden (GRID:grid.4514.4) (ISNI:0000 0001 0930 2361)
3 Aarhus University Hospital, Department of Cardiothoracic and Vascular Surgery, Skejby, Denmark (GRID:grid.154185.c) (ISNI:0000 0004 0512 597X)
4 Karolinska University Hospital, Department of Thoracic and Cardiovascular Surgery, Stockholm, Sweden (GRID:grid.24381.3c) (ISNI:0000 0000 9241 5705)
5 University of Gothenburg, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg, Sweden (GRID:grid.8761.8) (ISNI:0000 0000 9919 9582); Sahlgrenska University Hospital, Department of Cardiothoracic Surgery, Gothenburg, Sweden (GRID:grid.1649.a) (ISNI:000000009445082X)
6 Copenhagen University Hospital, Department of Cardiothoracic Surgery, The Heart Centre, Rigshospitalet, Copenhagen, Denmark (GRID:grid.4973.9) (ISNI:0000 0004 0646 7373)
7 Helsinki University Hospital, Heart and Lung Center, Helsinki, Finland (GRID:grid.15485.3d) (ISNI:0000 0000 9950 5666)
8 Tampere University Hospital and University of Tampere, Heart Centre, Tampere, Finland (GRID:grid.412330.7) (ISNI:0000 0004 0628 2985)
9 Turku University Hospital, Heart Center, Turku, Finland (GRID:grid.410552.7) (ISNI:0000 0004 0628 215X); Brigham and Women’s Hopistal and Harvard Medical School, Boston, USA (GRID:grid.38142.3c) (ISNI:000000041936754X)
10 Örebro University Hospital, Department of Cardiothoracic and Vascular Surgery, Örebro, Sweden (GRID:grid.412367.5) (ISNI:0000 0001 0123 6208)
11 Yale University School of Medicine, Division of Cardiac Surgery, New Haven, USA (GRID:grid.47100.32) (ISNI:0000000419368710)
12 University of Iceland, Department of Cardiothoracic Surgery, Landspitali University Hospital and Faculty of Medicine, Reykjavik, Iceland (GRID:grid.14013.37) (ISNI:0000 0004 0640 0021)