Does surgeon workload per day affect outcomes after pulmonary lobectomies?

Area of Science:

• Thoracic Surgery
• Surgical Outcomes Research
• Patient Safety

Background:

• Pulmonary lobectomy is a common thoracic surgical procedure.
• Surgeon workload is a potential factor influencing patient outcomes.
• Understanding workload impact is crucial for improving patient safety.

Purpose of the Study:

• To evaluate the association between surgeon workload and patient morbidity/mortality after pulmonary lobectomy.
• To identify specific workload metrics (e.g., operative hours, number of operations) that impact outcomes.
• To differentiate the impact of surgeon workload from patient-specific risk factors.

Main Methods:

• Retrospective review of 481 pulmonary lobectomy cases over two years (2007-2009).
• Analysis included surgeon workload metrics and individual patient variables.
• Univariate and multivariate analyses were performed to identify risk factors.

Main Results:

• Increased daily operative hours for surgeons were independently associated with higher complication rates (OR 1.036, p=0.03).
• Longer operative days also correlated with increased length of hospital stay (0.16 days/hour, p=0.006).
• Patient factors like age, reduced forced expiratory volume, and renal failure were also significant predictors of outcome.

Conclusions:

• Total daily operative hours represent an independent risk factor for complications in pulmonary lobectomy.
• Surgeon fatigue from extended operative days may contribute to increased patient morbidity.
• Further multi-institutional studies are needed to elucidate the interplay between surgeon workload and patient variables.