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Once after a full moon : acute type A aortic dissection and lunar phases

Bjursten, Henrik LU ; Oudin Åström, Daniel LU ; Nozohoor, Shahab LU orcid ; Ahmad, Khalil ; Tang, Mariann ; Bjurbom, Markus ; Hansson, Emma C. ; Jeppsson, Anders ; Joost Holdflod Møller, Christian and Jormalainen, Miko , et al. (2022) In Interactive Cardiovascular and Thoracic Surgery 34(1). p.105-110
Abstract

OBJECTIVES: Acute type A aortic dissection (ATAAD) is a rare but severe condition, routinely treated with emergent cardiac surgery. Many surgeons have the notion that patients with ATAAD tend to come in clusters, but no studies have examined these observations. This investigation was undertaken to study the potential association between the lunar cycle and the incidence of ATAAD. METHODS: We collected information on 2995 patients who underwent ATAAD surgery at centres from the Nordic Consortium for Acute Type A Aortic Dissection collaboration. We cross-referenced the time of surgery with lunar phase using a case-crossover design with 2 different definitions of full moon (>99% illumination and the 7-day full moon period). RESULTS: The... (More)

OBJECTIVES: Acute type A aortic dissection (ATAAD) is a rare but severe condition, routinely treated with emergent cardiac surgery. Many surgeons have the notion that patients with ATAAD tend to come in clusters, but no studies have examined these observations. This investigation was undertaken to study the potential association between the lunar cycle and the incidence of ATAAD. METHODS: We collected information on 2995 patients who underwent ATAAD surgery at centres from the Nordic Consortium for Acute Type A Aortic Dissection collaboration. We cross-referenced the time of surgery with lunar phase using a case-crossover design with 2 different definitions of full moon (>99% illumination and the 7-day full moon period). RESULTS: The period when the moon was illuminated the most (99% definition) did not show any significant increase in incidence for ATAAD surgery. However, when the full moon period was compared with all other moon phases, it yielded a relative risk of 1.08 [95% confidence interval (CI) 1.00-1.17, P = 0.057] and, compared to waxing moon, only the relative risk was 1.11 (95% CI 1.01-1.23, P = 0.027). The peak incidence came 4-6 days after the moon was fully illuminated. CONCLUSIONS: This study found an overrepresentation of surgery for ATAAD during the full moon phase. The explanation for this is not known, but we speculate that sleep deprivation during full moon leads to a temporary increase in blood pressure, which in turn could trigger rupture of the aortic wall. While this finding is interesting, it needs to be corroborated and the clinical implications are debateable.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Dissection of the aorta, Moon
in
Interactive Cardiovascular and Thoracic Surgery
volume
34
issue
1
pages
105 - 110
publisher
European Association of Cardio-Thoracic Surgery
external identifiers
  • scopus:85123459859
  • pmid:34999801
ISSN
1569-9285
DOI
10.1093/icvts/ivab220
language
English
LU publication?
yes
additional info
Publisher Copyright: © The Author(s) 2021. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.
id
22d71ebf-c2b6-4839-b99d-6ea6868756d4
date added to LUP
2022-02-07 08:11:44
date last changed
2024-11-29 04:57:36
@article{22d71ebf-c2b6-4839-b99d-6ea6868756d4,
  abstract     = {{<p>OBJECTIVES: Acute type A aortic dissection (ATAAD) is a rare but severe condition, routinely treated with emergent cardiac surgery. Many surgeons have the notion that patients with ATAAD tend to come in clusters, but no studies have examined these observations. This investigation was undertaken to study the potential association between the lunar cycle and the incidence of ATAAD. METHODS: We collected information on 2995 patients who underwent ATAAD surgery at centres from the Nordic Consortium for Acute Type A Aortic Dissection collaboration. We cross-referenced the time of surgery with lunar phase using a case-crossover design with 2 different definitions of full moon (&gt;99% illumination and the 7-day full moon period). RESULTS: The period when the moon was illuminated the most (99% definition) did not show any significant increase in incidence for ATAAD surgery. However, when the full moon period was compared with all other moon phases, it yielded a relative risk of 1.08 [95% confidence interval (CI) 1.00-1.17, P = 0.057] and, compared to waxing moon, only the relative risk was 1.11 (95% CI 1.01-1.23, P = 0.027). The peak incidence came 4-6 days after the moon was fully illuminated. CONCLUSIONS: This study found an overrepresentation of surgery for ATAAD during the full moon phase. The explanation for this is not known, but we speculate that sleep deprivation during full moon leads to a temporary increase in blood pressure, which in turn could trigger rupture of the aortic wall. While this finding is interesting, it needs to be corroborated and the clinical implications are debateable.</p>}},
  author       = {{Bjursten, Henrik and Oudin Åström, Daniel and Nozohoor, Shahab and Ahmad, Khalil and Tang, Mariann and Bjurbom, Markus and Hansson, Emma C. and Jeppsson, Anders and Joost Holdflod Møller, Christian and Jormalainen, Miko and Juvonen, Tatu and Mennander, Ari and Olsen, Peter S. and Olsson, Christian and Ahlsson, Anders and Oudin, Anna and Pan, Emily and Raivio, Peter and Wickbom, Anders and Sjögren, Johan and Geirsson, Arnar and Gudbjartsson, Tomas and Zindovic, Igor}},
  issn         = {{1569-9285}},
  keywords     = {{Dissection of the aorta; Moon}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{105--110}},
  publisher    = {{European Association of Cardio-Thoracic Surgery}},
  series       = {{Interactive Cardiovascular and Thoracic Surgery}},
  title        = {{Once after a full moon : acute type A aortic dissection and lunar phases}},
  url          = {{http://dx.doi.org/10.1093/icvts/ivab220}},
  doi          = {{10.1093/icvts/ivab220}},
  volume       = {{34}},
  year         = {{2022}},
}