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Updated: Jul 10, 2026

Collecting Sleep, Circadian, Fatigue, and Performance Data in Complex Operational Environments
08:36

Collecting Sleep, Circadian, Fatigue, and Performance Data in Complex Operational Environments

Published on: August 8, 2019

We still need to operate at night!

Omar Faiz1, Saswata Banerjee, Paris Tekkis

  • 1Department of General Surgery, Kings College Hospital, Denmark Hill, London, UK. omarfaiz@aol.com.

World Journal of Emergency Surgery : WJES
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PubMed
Summary

Emergency general surgery workload analysis shows a consistent need for complex procedures after midnight. Daytime and evening operating absorbed increased case volumes, while night-time procedures remained stable but decreased proportionally.

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Area of Science:

  • Surgical workload analysis
  • Healthcare management
  • Emergency medicine

Background:

  • Previous recommendations (National Confidential Enquiry into Peri-operative deaths) advised reducing non-essential night-time operating in NHS hospitals.
  • This study retrospectively analyzed emergency general surgical operative workload at a London Teaching hospital.

Purpose of the Study:

  • To analyze trends in emergency general surgical operative workload.
  • To assess the distribution of procedures across daytime, evening, and night-time slots.
  • To evaluate the impact of increasing workload on operating schedules.

Main Methods:

  • Retrospective analysis of 5,316 emergency general and vascular operations from 1997-2004.
  • Operations categorized by time: daytime (08:01-18:00), evening (18:01-00:00), and night-time (00:01-08:00).
  • Bivariate correlation used to analyze trends in workload and timing.

Main Results:

  • Night-time operations (9.8%) predominantly involved complex procedures like laparotomies and vascular surgery.
  • The annual volume of emergency cases increased significantly, absorbed by enhanced daytime and evening operating.
  • No significant change in absolute night-time cases, but their proportion of the total workload decreased.

Conclusions:

  • A consistent, albeit small, volume of complex emergency surgeries is required after midnight.
  • Emergency general surgical services must continue to accommodate these critical night-time procedures.