Sep 23 2009
The October issue of the journal Anesthesiology contains a study reviewing potential adverse effects associated with the timing of a patient's heart surgery; but based on this study, there is no bad time of the day or week or year to have elective coronary artery bypass graft surgery.
Research indicates that sleep deficits, natural body rhythm disturbances, and prolonged duty all reduce performance of drivers and pilots. This study's authors tested the theory that the same adverse effects may impact hospital personnel performance. Hospital personnel often work off-hours and pull long shifts. The study investigators thus expected surgical outcomes to be worse at the end of the day and at the end of the week when personnel are likely most fatigued. Similarly, outcomes might be worse in July when new resident physician trainees, fresh out of medical school or newly promoted to perform more demanding duties, start working.
Coronary artery bypass grafting was studied because it is the most common heart surgery, and because there are well-established protocols for the procedure. The analysis was limited to elective operations because emergency procedures are inherently riskier and are often performed in patients with additional medical problems.
"We started the study believing that timing was likely to influence outcome. If so, hospitals could intervene with precautions to improve patient safety during high-risk periods," said Allen Bashour, M.D., the study's senior investigator. "However, our results showed that serious complications were rare and that the timing of elective surgery did not influence the outcome."
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