Risks of complications by attending physicians after performing nighttime procedures
Objective: To determine whether sleep opportunities for attending surgeons and obstetricians/gynecologists are associated with the risk of complications. Design: Matched retrospective cohort study of procedures performed from 1999 to 2008 by attending physicians (86 surgeons, 134 obstetricians/gynec...
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Veröffentlicht in: | Canadian Journal of Surgery 2012-10, Vol.55 (5), p.337-339 |
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description | Objective: To determine whether sleep opportunities for attending surgeons and obstetricians/gynecologists are associated with the risk of complications. Design: Matched retrospective cohort study of procedures performed from 1999 to 2008 by attending physicians (86 surgeons, 134 obstetricians/gynecologists) who had been in hospital performing another procedure in adult patients for at least part of the preceding night (12:00-6:00 am postnighttime procedures). Results: A total of 9191 surgical and 957 obstetrical postnighttime procedures were matched with 3552 and 3945 control procedures, respectively. Complications occurred in 101 postnighttime procedures (5.4%) and 365 control procedures (4.9%; odds ratio [OR] 1.09, 95% confidence interval [CI] 0.84-1.41). Complications occurred in 82 of 1317 (6.2%) postnighttime procedures performed by surgeons who had 6 hours of sleep or fewer versus 19 of 559 (3.4%) postnighttime procedures performed by surgeons who had more than 6 hours of sleep (OR 1.72, 95% CI 1.02-2.89). Postnighttime procedures completed after working more than 12 hours (n = 958) compared with 12 hours or fewer (n = 918) had nonsignificantly higher complication rates (6.5% v. 4.3%; OR 1.47, 95% CI 0.96-2.27). Conclusion: Overall, procedures performed the day after attending physicians worked overnight were not associated with significantly increased complication rates, although there was an increased rate of complications for postnighttime procedures performed by physicians who had fewer than 6 hours of sleep. |
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Design: Matched retrospective cohort study of procedures performed from 1999 to 2008 by attending physicians (86 surgeons, 134 obstetricians/gynecologists) who had been in hospital performing another procedure in adult patients for at least part of the preceding night (12:00-6:00 am postnighttime procedures). Results: A total of 9191 surgical and 957 obstetrical postnighttime procedures were matched with 3552 and 3945 control procedures, respectively. Complications occurred in 101 postnighttime procedures (5.4%) and 365 control procedures (4.9%; odds ratio [OR] 1.09, 95% confidence interval [CI] 0.84-1.41). Complications occurred in 82 of 1317 (6.2%) postnighttime procedures performed by surgeons who had 6 hours of sleep or fewer versus 19 of 559 (3.4%) postnighttime procedures performed by surgeons who had more than 6 hours of sleep (OR 1.72, 95% CI 1.02-2.89). Postnighttime procedures completed after working more than 12 hours (n = 958) compared with 12 hours or fewer (n = 918) had nonsignificantly higher complication rates (6.5% v. 4.3%; OR 1.47, 95% CI 0.96-2.27). Conclusion: Overall, procedures performed the day after attending physicians worked overnight were not associated with significantly increased complication rates, although there was an increased rate of complications for postnighttime procedures performed by physicians who had fewer than 6 hours of sleep.</description><identifier>ISSN: 0008-428X</identifier><identifier>EISSN: 1488-2310</identifier><identifier>DOI: 10.1503/cjs.018212</identifier><identifier>CODEN: CJSUAX</identifier><language>eng</language><publisher>Ottawa: CMA Joule Inc</publisher><subject>Analysis ; Health aspects ; Influence ; Patient safety ; Peer review ; Physicians ; Practice ; Sleep deprivation ; Statistics ; Surgeons ; Surgical errors ; Working hours</subject><ispartof>Canadian Journal of Surgery, 2012-10, Vol.55 (5), p.337-339</ispartof><rights>COPYRIGHT 2012 CMA Joule Inc.</rights><rights>Copyright Canadian Medical Association Oct 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c525t-f16ebfd22836b3c0ab5b4f954fd3d391116e0c4054304ab30552b159192cdcdd3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids></links><search><creatorcontrib>Chaudhury, Prosanto K</creatorcontrib><creatorcontrib>Warnock, Garth L</creatorcontrib><creatorcontrib>Whalen, Thomas V</creatorcontrib><title>Risks of complications by attending physicians after performing nighttime procedures</title><title>Canadian Journal of Surgery</title><description>Objective: To determine whether sleep opportunities for attending surgeons and obstetricians/gynecologists are associated with the risk of complications. Design: Matched retrospective cohort study of procedures performed from 1999 to 2008 by attending physicians (86 surgeons, 134 obstetricians/gynecologists) who had been in hospital performing another procedure in adult patients for at least part of the preceding night (12:00-6:00 am postnighttime procedures). Results: A total of 9191 surgical and 957 obstetrical postnighttime procedures were matched with 3552 and 3945 control procedures, respectively. Complications occurred in 101 postnighttime procedures (5.4%) and 365 control procedures (4.9%; odds ratio [OR] 1.09, 95% confidence interval [CI] 0.84-1.41). Complications occurred in 82 of 1317 (6.2%) postnighttime procedures performed by surgeons who had 6 hours of sleep or fewer versus 19 of 559 (3.4%) postnighttime procedures performed by surgeons who had more than 6 hours of sleep (OR 1.72, 95% CI 1.02-2.89). Postnighttime procedures completed after working more than 12 hours (n = 958) compared with 12 hours or fewer (n = 918) had nonsignificantly higher complication rates (6.5% v. 4.3%; OR 1.47, 95% CI 0.96-2.27). Conclusion: Overall, procedures performed the day after attending physicians worked overnight were not associated with significantly increased complication rates, although there was an increased rate of complications for postnighttime procedures performed by physicians who had fewer than 6 hours of sleep.</description><subject>Analysis</subject><subject>Health aspects</subject><subject>Influence</subject><subject>Patient safety</subject><subject>Peer review</subject><subject>Physicians</subject><subject>Practice</subject><subject>Sleep deprivation</subject><subject>Statistics</subject><subject>Surgeons</subject><subject>Surgical errors</subject><subject>Working hours</subject><issn>0008-428X</issn><issn>1488-2310</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNpt0t2L1DAQAPAgCq6nL_4FRUHOg675rM3jcfhxcCjoCb6FNJl0s7ZNL0nh9r836wreypKHwMwvkyEZhF4SvCYCs3dmm9aYtJTQR2hFeNvWlBH8GK0wxm3NafvzKXqW0hZjghmXK3T7zadfqQquMmGcB2909mFKVberdM4wWT_11bzZJW-8LnHtMsRqhuhCHPe5yfebnP0I1RyDAbtESM_RE6eHBC_-7mfox8cPt1ef65uvn66vLm9qI6jItSMNdM5S2rKmYwbrTnTcScGdZZZJQkoeG44FZ5jrjmEhaEeEJJIaa6xlZ-j8ULdcfbdAymr0ycAw6AnCkhShreANlpIV-vo_ug1LnEp3iuC2Ybx5L8k_1esBlJ9cyFGbfVF1WXqQnIqWFlWfUD1MEPUQJnC-hI_8qxPezP5OPUTrE6gsC6M3J6u-PTpQTIb73OslJXX9_cuxffPAbkAPeZPCsPz562N4cYAmhpQiODVHP-q4K6-k9hOmyoSpw4Sx31o8vv4</recordid><startdate>20121001</startdate><enddate>20121001</enddate><creator>Chaudhury, Prosanto K</creator><creator>Warnock, Garth L</creator><creator>Whalen, Thomas V</creator><general>CMA Joule Inc</general><general>CMA Impact, Inc</general><scope>AAYXX</scope><scope>CITATION</scope><scope>ISN</scope><scope>3V.</scope><scope>4T-</scope><scope>4U-</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8FQ</scope><scope>8FV</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M3G</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope></search><sort><creationdate>20121001</creationdate><title>Risks of complications by attending physicians after performing nighttime procedures</title><author>Chaudhury, Prosanto K ; Warnock, Garth L ; Whalen, Thomas V</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c525t-f16ebfd22836b3c0ab5b4f954fd3d391116e0c4054304ab30552b159192cdcdd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Analysis</topic><topic>Health aspects</topic><topic>Influence</topic><topic>Patient safety</topic><topic>Peer review</topic><topic>Physicians</topic><topic>Practice</topic><topic>Sleep deprivation</topic><topic>Statistics</topic><topic>Surgeons</topic><topic>Surgical errors</topic><topic>Working hours</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chaudhury, Prosanto K</creatorcontrib><creatorcontrib>Warnock, Garth L</creatorcontrib><creatorcontrib>Whalen, Thomas V</creatorcontrib><collection>CrossRef</collection><collection>Gale In Context: Canada</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>University Readers</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Canadian Business & Current Affairs Database</collection><collection>Canadian Business & Current Affairs Database (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>CBCA Reference & Current Events</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><jtitle>Canadian Journal of Surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chaudhury, Prosanto K</au><au>Warnock, Garth L</au><au>Whalen, Thomas V</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risks of complications by attending physicians after performing nighttime procedures</atitle><jtitle>Canadian Journal of Surgery</jtitle><date>2012-10-01</date><risdate>2012</risdate><volume>55</volume><issue>5</issue><spage>337</spage><epage>339</epage><pages>337-339</pages><issn>0008-428X</issn><eissn>1488-2310</eissn><coden>CJSUAX</coden><abstract>Objective: To determine whether sleep opportunities for attending surgeons and obstetricians/gynecologists are associated with the risk of complications. Design: Matched retrospective cohort study of procedures performed from 1999 to 2008 by attending physicians (86 surgeons, 134 obstetricians/gynecologists) who had been in hospital performing another procedure in adult patients for at least part of the preceding night (12:00-6:00 am postnighttime procedures). Results: A total of 9191 surgical and 957 obstetrical postnighttime procedures were matched with 3552 and 3945 control procedures, respectively. Complications occurred in 101 postnighttime procedures (5.4%) and 365 control procedures (4.9%; odds ratio [OR] 1.09, 95% confidence interval [CI] 0.84-1.41). Complications occurred in 82 of 1317 (6.2%) postnighttime procedures performed by surgeons who had 6 hours of sleep or fewer versus 19 of 559 (3.4%) postnighttime procedures performed by surgeons who had more than 6 hours of sleep (OR 1.72, 95% CI 1.02-2.89). Postnighttime procedures completed after working more than 12 hours (n = 958) compared with 12 hours or fewer (n = 918) had nonsignificantly higher complication rates (6.5% v. 4.3%; OR 1.47, 95% CI 0.96-2.27). Conclusion: Overall, procedures performed the day after attending physicians worked overnight were not associated with significantly increased complication rates, although there was an increased rate of complications for postnighttime procedures performed by physicians who had fewer than 6 hours of sleep.</abstract><cop>Ottawa</cop><pub>CMA Joule Inc</pub><doi>10.1503/cjs.018212</doi><tpages>3</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Analysis Health aspects Influence Patient safety Peer review Physicians Practice Sleep deprivation Statistics Surgeons Surgical errors Working hours |
title | Risks of complications by attending physicians after performing nighttime procedures |
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