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Sleepless Surgeons; Does it Affect Surgical Outcomes?


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8/31/2015
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Many surgeons are on call for many hours at a time and lack sleep. Are they still able to give their patients the care they need during this state?

CBS news reports on new research.

Experts are saying that patients need not worry about whether their sleepless surgeon has slept enough.

The study surprisingly showed that the risk of death or complications after surgery was no more likely if the surgeon pulled a midnight shift before a daytime operation.

The study’s senior author, Dr. Nancy Baxter, surgery division chief at St. Michael's Hospital in Toronto commented on the findings. She said, “I believe what we are seeing in our study reflects self-regulation -- that surgeons plan around their schedules based on their individual ability to tolerate sleep deprivation. Given our findings, they seem to be doing a good job of it.”

The New England Journal of Medicine published the study on Wednesday.

How was the study conducted?

The team looked at the findings of around 39,000 patients undergoing one of 12 daytime surgeries, including gallbladder removal and hysterectomy.

The study’s experts actually paired patients who'd had the same surgeon perform the same procedure. In each set, one patient got the surgeon after a night shift and the other got the same physician fresh off of seven or more hours of not treating patients.

What were the results?

By the end, the comparison encompassed more than 1,400 surgeons and looked at how their patients fared 30 days after their operation.

“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,” according to CBS.

Despite the fact that these results should reassure patients planning elective surgery, Dr. Carlos Pellegrini, past president of the American College of Surgeons and chair of surgery at University of Washington Medicine in Seattle, finds them worrisome.

He referred to the findings as very polished but also said that ‘my only concern is that those who have been hounding this idea that we can spend all night operating and operate in the morning, don't take this paper as saying that you can do that and have the same outcomes’. Dr. Baxter, the study author, agreed with this point.

Dr. Baxter said, “Taking away the ability for physicians to self-regulate the work they do the day after being on call would really have the potential to cause harm. Sleep deprivation affects us all, and some people deal with it poorly and some deal with it well, and only the individual physician can really judge this.”

Dr. Pellegrini also noted that outcomes after 30 days are only short term measures. He explained that you are not looking at little details that would otherwise be hidden and not seen. For example, the results of morning operations including cancer where you remove an extra lymph node or do a dissection that is a little more precise would only be apparent five years later, if you survived the cancer, depending on what stage you were in.

Read the source article here.



Category: Surgical Mistakes


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