BACKGROUND: There is growing support in the literature that patient outcomes are adversely affected by physician fatigue in operator-dependent cognitive and technical tasks. Recent increases in total joint arthroplasty caseloads have resulted in longer operative days and increased surgeon fatigue. We sought to determine if time of day predicts perioperative complications and outcomes in total joint arthroplasty. METHODS: The records of all total hip and knee arthroplasties (THA; TKA) performed for primary osteoarthritis in one calendar year at one large university hospital were retrospectively reviewed. Demographic data, surgery start time and duration, intraoperative complications, radiographic component alignment and functional outcome scores (SF-12 and Western Ontario and McMaster Universities Osteoarthritis Index) were collected and analyzed using linear and nonparametric rank correlation statistics. Data were corrected for sex, body mass index, surgeon and postcall operating days. RESULTS: In the THA cohort (n=341), a later surgery start time was significantly related to duration of surgery (p= 0.004, mean difference -7.1 min). There was a trend toward significance between a later surgery start time and intraoperative femur fracture (p= 0.05). Postoperative complications, component alignment and functional outcome scores were not significantly affected by surgery start time. There were no significant findings for any of the intraoperative or postoperative outcomes in the TKA cohort (n=292). CONCLUSION: Duration of surgery and incidence of intraoperative complications for THA may increase with later surgery start time; however, the relatively small statistical differences observed imply that they likely are not clinically significant.
BACKGROUND: There is growing support in the literature that patient outcomes are adversely affected by physician fatigue in operator-dependent cognitive and technical tasks. Recent increases in total joint arthroplasty caseloads have resulted in longer operative days and increased surgeon fatigue. We sought to determine if time of day predicts perioperative complications and outcomes in total joint arthroplasty. METHODS: The records of all total hip and knee arthroplasties (THA; TKA) performed for primary osteoarthritis in one calendar year at one large university hospital were retrospectively reviewed. Demographic data, surgery start time and duration, intraoperative complications, radiographic component alignment and functional outcome scores (SF-12 and Western Ontario and McMaster Universities Osteoarthritis Index) were collected and analyzed using linear and nonparametric rank correlation statistics. Data were corrected for sex, body mass index, surgeon and postcall operating days. RESULTS: In the THA cohort (n=341), a later surgery start time was significantly related to duration of surgery (p= 0.004, mean difference -7.1 min). There was a trend toward significance between a later surgery start time and intraoperative femur fracture (p= 0.05). Postoperative complications, component alignment and functional outcome scores were not significantly affected by surgery start time. There were no significant findings for any of the intraoperative or postoperative outcomes in the TKA cohort (n=292). CONCLUSION: Duration of surgery and incidence of intraoperative complications for THA may increase with later surgery start time; however, the relatively small statistical differences observed imply that they likely are not clinically significant.
Authors: Madhusudhan R Sanaka; Nirav Shah; Kevin D Mullen; D R Ferguson; Charles Thomas; Arthur J McCullough Journal: Am J Gastroenterol Date: 2006-12 Impact factor: 10.864
Authors: Katrina N Slaughter; Michael Frumovitz; Kathleen M Schmeler; Alpa M Nick; Nicole D Fleming; Ricardo dos Reis; Mark F Munsell; Shannon N Westin; Pamela T Soliman; Pedro T Ramirez Journal: Gynecol Oncol Date: 2014-06-16 Impact factor: 5.482
Authors: Jin Wang; Javier Cabrera; Kwok-Leung Tsui; Hainan Guo; Monique Bakker; John B Kostis Journal: J Healthc Eng Date: 2020-02-10 Impact factor: 2.682