Naoya Koda1, Yoko Oshima2, Keiji Koda3, Hideaki Shimada4. 1. Toho University School of Medicine, 5-21-16, Omori-nishi, Ota-ku, Tokyo, Japan. 2. Division of Gastroenterological Surgery, Department of Surgery, Toho University Medical Center, Omori Hospital, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan. 3. Department of Surgery, Teikyo University Chiba Medical Center, Ichihara, Chiba, Japan. 4. Department of Gastroenterological Surgery and Clinical Oncology, Graduate School of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo, Japan. hideaki.shimada@med.toho-u.ac.jp.
Abstract
PURPOSE: To systematically review the effects of surgeon fatigue on postoperative mortality and postoperative complications after elective and non-elective surgeries. METHODS: A database search was conducted for original articles published in PubMed between 2000 and 2020 with the keywords: "surgeon," "sleep deprivation," "sleep deprived," "fatigued," "mortality," "morbidity," and "outcomes." We selected articles that disclosed actual numbers of patients who underwent surgery by fatigued or rested surgeons, rates of postoperative mortality, or total postoperative complications. RESULTS: Of the 1427 articles identified, 16 met the selection criteria and were included. Eight of the 16 also included total postoperative complications. Analysis revealed no significant differences in the rates of postoperative mortality after elective and non-elective surgeries or total postoperative complications of elective surgeries or non-elective surgeries performed by fatigued vs. rested surgeons. The relative risks were 1.03 [95% confidence interval (CI), 0.86-1.24], 1.08 (95% CI, 0.85-1.38), 0.99 (95% CI, 0.95-1.04), and 0.93 (95% CI, 0.67-1.28), respectively. CONCLUSION: Surgeon fatigue does not affect the rates of postoperative mortality or total postoperative complications after elective surgeries and may have little to no effect on the rates of postoperative mortality or total postoperative complications after non-elective surgeries.
PURPOSE: To systematically review the effects of surgeon fatigue on postoperative mortality and postoperative complications after elective and non-elective surgeries. METHODS: A database search was conducted for original articles published in PubMed between 2000 and 2020 with the keywords: "surgeon," "sleep deprivation," "sleep deprived," "fatigued," "mortality," "morbidity," and "outcomes." We selected articles that disclosed actual numbers of patients who underwent surgery by fatigued or rested surgeons, rates of postoperative mortality, or total postoperative complications. RESULTS: Of the 1427 articles identified, 16 met the selection criteria and were included. Eight of the 16 also included total postoperative complications. Analysis revealed no significant differences in the rates of postoperative mortality after elective and non-elective surgeries or total postoperative complications of elective surgeries or non-elective surgeries performed by fatigued vs. rested surgeons. The relative risks were 1.03 [95% confidence interval (CI), 0.86-1.24], 1.08 (95% CI, 0.85-1.38), 0.99 (95% CI, 0.95-1.04), and 0.93 (95% CI, 0.67-1.28), respectively. CONCLUSION: Surgeon fatigue does not affect the rates of postoperative mortality or total postoperative complications after elective surgeries and may have little to no effect on the rates of postoperative mortality or total postoperative complications after non-elective surgeries.