A 6-year prospective study from a team of Canadian researchers has found no evidence that the length of sleep for consultant surgeons during the night before performing a surgery has an effect on postoperative outcomes. The finding is based on information collected between January 2004 and December 2009 on sleep hours of six consultant surgeons aged 32 to 55 who worked in the London Health Sciences Centre in Ontario.

The prospective study cohort consisted of patients undergoing coronary artery bypass, valve, combined valve-coronary artery bypass, and aortic surgery. Michael Chu, MD, and colleagues used their own institutional multivariable model to calculate predicted risk of death and/or any of 10 major complications:

1. Use of postoperative intra-aortic balloon pump.
2. Stroke or delirium.
3. Reoperation for bleeding.
4. Arrest or permanent pacemaker.
5. New renal failure.
6. Septicemia.
7. Mediastinitis.
8. Sternal dehiscence.
9. Respiratory failure.
10. Postoperative myocardial infarction.

The interaction among surgeon age, sleep hours, and postoperative outcomes was examined using additional pre-specified analyses.

The study group split 4,047 consecutive surgeries into those performed by a consultant who received 0 to 3 hours of sleep (83), 3 to 6 hours of sleep (1,595), or more than 6 hours of sleep (2,369). For the three groups, mortality rates were 3.6% (3), 2.8% (44), and 3.4% (80), respectively. Observed versus expected major complication ratios were similar: 1.20 in the 0 to 3 hours group, 0.95 in the 3 to 6 hours group, and 1.07 in the 6 hours or more group. Additionally, no significant links were seen between surgeon age, hours of sleep, and occurrence of death or any major complications.

Based on the findings and conclusions, it would seem that consultant surgeon sleep deprivation does not appear to affect the quality of outcomes or patient safety. However, it’s important to note that the study looked at only six surgeons who were working at a single site and who performed a limited range of surgery types.

Physician’s Weekly wants to know…

  • Do you think these findings can be extrapolated out to all surgeons, or is this study too small to make any broad conclusions?
  • What have you seen in your hospital with regards to sleep and surgery outcomes?
  • Do you feel a relationship does exist between sleep hours and surgery outcomes? What about a link between level of sleep and basic job performance of any health care provider?