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Patients who have surgery on the surgeon's birthday have a higher mortality rate than patients who have surgery on other days of the year. A US study can be found in the Christmas edition of the BMJ.
These results suggest that surgeons may be distracted by life events not directly related to work, the researchers say.
Laboratory experiments have shown that common distractions in the operating room such as noise, equipment problems, and face-to-face conversations can adversely affect surgeon performance. The use of real data, however, has only limited evidence.
One theory is that surgeons may be more distracted or rush to complete the procedures on their birthdays, so patient outcomes may be different on those days.
To test this theory, the researchers used the nationally representative Medicare data of the elderly population in the United States to study death within 30 days of surgery in patients aged 65 to 99 who underwent a 2011-2014 of 17 common emergency surgical procedures in US hospitals
This was linked to information about the surgeon's birthdays and factors such as the age and severity of the patient's disease, the surgeon's specialty and the hospital staff were taken into account.
A total of 980,876 interventions by 47,489 surgeons were analyzed. Of these, 2,064 (0.2%) were performed on the surgeon's birthdays.
Patients who had surgery on a surgeon's birthday had a higher mortality rate than patients who had surgery on other days (6.9% on birthdays versus 5.6% on other days).
While this is significant, it is comparable to the impact of other events, including Christmas and New Year holidays and weekends, which have been claimed to affect the quality of care for patients, the researchers note.
In addition, after further analysis, the results were similar, e.g. B. after excluding surgeons with the highest patient mortality and adjusting to the timing of the surgery, suggesting they will stand up to scrutiny.
There are several possible explanations for these results, the researchers note.
For example, surgeons may feel rushed to complete the procedures on time on their birthday because they may have important evening plans. Birthday conversations with team members or birthday messages on their phones during surgery can also be distracting and lead to medical errors.
Or, compared to normal evenings, surgeons may be less likely to return to the hospital to see their patients showing signs of deterioration when they have dinner with family and friends.
This is an observational study, so no cause can be identified, and the researchers say they couldn't investigate the cause of death or rule out the effects of other unmeasured factors. The focus on common procedures in Medicare elderly patients also means that the results may not apply to other patient populations or surgical procedures.
Taken together, however, these results suggest that a surgeon's performance could be affected by life events not directly related to work, the researchers say.
While this hypothesis is intuitive, it has otherwise been difficult to evaluate due to the lack of detailed information on events that may distract an individual surgeon.
Emergency treatment by elderly surgeons associated with slightly lower mortality rates
More information:
Patient mortality after surgery on the surgeon's birthday: observational study, BMJ (2020). DOI: 10.1136 / bmj.m4381
Provided by
British Medical Journal
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Patient mortality higher on surgeons' birthdays (2020, December 10th)
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