Risks of complications by attending physicians after performing nighttime procedures

Area of Science:

• Medical research
• Surgical outcomes
• Patient safety

Background:

• Limited data exists on the impact of physician work hours and sleep on patient safety.
• Understanding the relationship between physician fatigue and medical errors is crucial.

Purpose of the Study:

• To investigate the association between sleep opportunities for attending surgeons and obstetricians/gynecologists and the risk of patient complications.
• To analyze complication rates in procedures performed after overnight shifts.

Main Methods:

• A matched retrospective cohort study analyzed procedures performed by attending physicians (surgeons, obstetricians/gynecologists) from 1999-2008.
• Sleep opportunity was defined as time between overnight procedures and subsequent procedures.
• Complications were assessed using a blinded, multi-step review process.

Main Results:

• Overall complication rates were similar between post-overnight procedures and controls (5.4% vs 4.9%).
• Procedures performed by physicians with less than 6 hours of sleep opportunity showed a higher complication rate (6.2% vs 3.4%).
• No significant increase in complications was observed for procedures after more than 12 hours of work compared to 12 hours or less.

Conclusions:

• Procedures performed the day after attending physicians worked overnight were not linked to significantly higher overall complication rates.
• An increased complication rate was noted for post-overnight surgical procedures by physicians with less than 6 hours of sleep opportunity.
• Findings suggest a potential risk associated with limited sleep for surgeons performing procedures after overnight calls.