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

Research paper by Syed N SN Zafar, Laura L Libuit, Zain G ZG Hashmi, Kakra K Hughes, Wendy R WR Greene, Edward E EE Cornwell, Adil H AH Haider, Terrence M TM Fullum, Daniel D DD Tran

Indexed on: 15 Feb '15Published on: 15 Feb '15Published in: The American Journal of Surgery®


Sleepiness and fatigue affect surgical outcomes. We wished to determine the association between time of day and outcomes following surgery for trauma.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.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.Trauma surgery during the odd hours of the night did not have an increased risk-adjusted mortality when compared with surgery during the day.