Scheduling Your Operation?

Surgery time may not impact patient survival

(RxWiki News) Despite previous concerns about doctor fatigue, new findings suggest that the risk of mortality during elective surgical procedures is not impacted by the time of day for the operation.

A nighttime operation on Thursday would be just as safe as one  on Tuesday morning, alleviating concern raised by previous studies that evening surgeries or those later in the week would be riskier. There also was no increased risk of death during summer months when new residents generally begin at medical facilities.

"Schedule elective procedures with a doctor you trust."

Dr. Daniel I. Sessler, a study author from the Cleveland Clinic, said that factors such as fatigue, circadian rhythms, scheduling, and staffing could have an impact on patient care across medical specialties. However he noted that the new research suggests that elective surgery is safe, regardless of timing.

Researchers analyzed the outcomes of 32,001 elective surgeries performed at the Cleveland Clinic from 2005 to 2010. They then calculated the risk of death within 30 days of surgery according to the time of the day of the operation (between 6 a.m. and 7 p.m.), day of the week, month and year.

After 30 days, the overall death rate was .43 percent. After an adjustment for various factors, investigators found no evidence to suggest that time of day, day of the week, the month or the year played a role in survival.

A secondary analysis found no difference in complication rates for operations performed at various times or on different days. The overall in-hospital complication rate was 13 percent.

Dr. Sessler noted that the results apply to hospitals performing high-risk surgeries in a high-risk population and may not be representative of other types of hospitals.

In an accompanying editorial by Drs. Franklin Dexter and Alan P. Marco, they note that the results suggest that facilities can decide whether to add operating rooms or schedule operations late on busy days because patient safety will not be compromised.

The study was recently published in the December edition of journal Anesthesia & Analgesia.

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Review Date: 
November 28, 2011