Sleep-deprived surgeons don't increase patient safety risks

Lack of sleep among surgeons does not increase the risk of adverse patient outcomes, according to a new study published in the Journal of the American Medical Association.

Using data from 102 community hospitals, lead researcher Christopher Vinden, M.D., of Western University in London, Ontario and his team analyzed 2,000 surgeries performed by a surgeon who had operated the night before. The researchers compared these surgeries to four similar procedures by the same surgeons on days when they had not operated the night before, resulting in 10,390 total operations.

The main outcome of the surgeries, according to the study, was conversion from a laparoscopic cholecystectomy to open cholecystectomy. The researchers found no significant association in conversion rates to open operations between surgeons on the basis of whether they operated the previous night. "These findings do not support safety concerns related to surgeons operating the night before performing elective surgery," the researchers stated.

However, an editorial accompanying the study said that despite the study results, surgeons must decide for themselves whether they feel their level of exhaustion allows them to perform surgeries.

"[E]ach surgeon must objectively self-assess fatigue level and honestly determine whether the surgical skills necessary for daytime operations following operating the night before will be comparable to those skills and capabilities following a good night's sleep," wrote Michael J. Zinner, M.D., of Brigham and Women's Hospital in Boston and Julie Ann Fresichlag, M.D., of Johns Hopkins Medical Institute in Baltimore in the opinion piece. "Patient safety and surgeon well-being deserve no less."

A 2012 study found that although lack of sleep did not prevent surgeons from performing operations in which they were already trained, it left them less prepared to deal with unexpected events, due to sleep deprivation's "stress on brain workload," FierceHealthcare previously reported.

To learn more:
- read the study abstract
- read the editorial (subscription required)