The sleepy surgeon: does night-time surgery for trauma affect mortality outcomes?

Abstract

Background: Sleepiness and fatigue affect surgical outcomes. We wished to determine the association between time of day and outcomes following surgery for trauma.

Methods: From the National Trauma Data Bank (2007 to 2010), we analyzed all adults who underwent an exploratory laparotomy between midnight and 6 am or between 7 am and 5 pm. We compared hospital mortality between these groups using multivariate logistic regression. Additionally, for each hour, a standardized mortality ratio was calculated.

Results: About 16,096 patients and 15,109 patients were operated on in the night time and day time, respectively. No difference was found in the risk-adjusted mortality rate between the 2 time periods (odds ratio .97, 95% confidence interval .893 to 1.058). However, hourly variations in mortality during the 24-hour period were noted.

Conclusion: Trauma surgery during the odd hours of the night did not have an increased risk-adjusted mortality when compared with surgery during the day.

Keywords: Fatigue; Mortality; Trauma surgery; Work hours.