Surgeons Perform Well Despite Late Night and Early Morning Operations

Review indicates that doctors who operate the night before another surgery do well.
Review indicates that doctors who operate the night before another surgery do well.

(HealthDay News) -- The risk of death, hospital readmission, or complications following surgery is no more likely if the surgeon worked a midnight shift before a daytime operation, according to a study published in the New England Journal of Medicine.

Nancy Baxter, M.D., Ph.D., surgery division chief at St. Michael's Hospital in Toronto, and colleagues looked at results for 38,978 patients undergoing 1 of 12 elective daytime surgeries. For the analysis, the study authors paired patients who'd had the same surgeon perform the same procedure. In each pair, 1 patient got the surgeon after a night shift and the other got the same doctor returning from at least 7 hours of not treating patients. In the end, the comparison included 1,448 surgeons and looked at how their patients fared 30 days after their operation.

According to the researchers, it turned out that outcomes didn't differ between the patients based on whether or not their surgeons had worked the midnight shift before the day of surgery.

As for why the surgeons had equal outcomes whether they'd pulled a night shift or not, Baxter said that while it's possible that overnight work didn't affect their performance, she thinks that explanation is less likely than others. "More likely the current way doctors self-regulate mitigates the harms of overnight work for their patients," she told HealthDay. "For example, surgeons who don't tolerate sleep deprivation well may never schedule surgery the day after taking [an overnight] call." Another thing surgeons might do, she said, is to change their surgery plans for the next day by cancelling or delaying surgeries.

Source

  1. Govindarajan, A; Urbach, DR; Kumar, M; et al. N Engl J Med 2015; 373:845-853. August 27, 2015; doi: 10.1056/NEJMsa1415994.
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