'Mortality risk' of surgery on surgeon's birthday
Friday December 11th 2020
Patients who undergo surgery on their surgeon’s birthday face an increased mortality risk, according to a US-based study today, published as part of the tradition of quirky Christmas journal articles.
Researchers tested the theory that surgeons could be distracted by life events that are not directly related to work by analysing Medicare data of the elderly population in the USA.
It followed laboratory experiments in which common distractions in the operating room, such as noise, equipment problems, and personal conversations, were shown to have a detrimental effect on surgeons’ performance.
They looked specifically at data of patients aged 65 to 99, who died within 30 days of having surgery for one of 17 common emergency surgical procedures between 2011 and 2014.
The researchers in Los Angeles, California, linked this to information on surgeon birthdays, and took into account factors such as patient age and severity of illness, surgeon specialty, and hospital staffing levels. In total, they analysed 980,876 procedures performed by 47,489 surgeons.
Of these, 2,064 (0.2%) were performed on surgeons’ birthdays and they established that patients who underwent a surgical procedure on a surgeon’s birthday had a higher mortality rate – at 6.9% – compared with 5.6% of patients who underwent surgery on other days.
The results were similar after further analyses, such as excluding surgeons with the highest patient mortality and adjusting for timing of surgery.
Writing in the Christmas edition of The BMJ, the researchers say this is comparable to the impact of other events, including Christmas and New Year holidays and weekends, which are said to affect the quality of care patients receive.
They say possible explanations for these findings include: feeling rushed to complete procedures on time on because they might have important evening plans; birthday conversations with team members or distracting birthday messages on their phones, leading to medical errors; and less likely to return to hospital if a patient shows signs of deteriorating.
As it is an observational study, it cannot establish cause, and the researchers were unable to examine cause of death or exclude the impact of other unmeasured factors.
The same edition of The BMJ carries a study that says listening to soothing words and music during surgery could reduce pain levels and the need for post-operative pain-relieving drugs.
Researchers in Regensburg, Germany, carried out a trial with 385 patients, all aged 18-70 who were undergoing elective surgery of between one and three hours under general anaesthesia at five hospitals.
Patients were randomly split into two groups, with 191 in the intervention group and 194 in the control group.
While the intervention group was under general anaesthesia, they listened to an audiotape of background music and positive suggestions based on hypnotherapeutic principles, which was played repeatedly for 20 minutes followed by 10 minutes of silence.
Patients in the control group were assigned to a blank tape.
The researchers found that before surgery, patients in both groups reported similar pain levels, but in the first 24 hours after surgery, pain scores were consistently and significantly lower in the intervention group, with an average reduction of 25%.
The intervention group were also prescribed fewer opioids in the first 24 hours after surgery, with 121 (63%) compared to 155 out of 194 (80%) in the control group.
The researchers say the results suggest that therapeutic suggestions played through earphones during general anaesthesia “could provide a safe, feasible, inexpensive, and non-drug technique to reduce postoperative pain and opioid use, with the potential for more general use”.
Kato H, Jena AB, Tsugawa Y. Patient mortality after surgery on the surgeon’s birthday: observational study. BMJ 11 December 2020
Nowak H, Zech N, Asmussen S et al. Soothing words and music during surgery might reduce postoperative pain. BMJ 11 December 2020
Tags: Europe | General Health | North America
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