By: 2 September 2016
Five-year study reveals patients operated on at night twice as likely to die as patients who have daytime operations

New research presented at this year’s World Congress of Anaesthesiologists (WCA) in Hong Kong in September shows that patients who have surgery during the night are twice as likely to die as patients operated on during regular working hours.

Patients operated on later in the working day or in the early evening also have a higher mortality risk, concludes the study by Dr Michael Tessler, Associate Professor of Anesthesiology at McGill University Health Centre, Montreal, Canada, and colleagues.

The aim of this study was to investigate relationship between postoperative mortality and the time of the day of surgery at a Canadian hospital. A retrospective review of 30-day postoperative in hospital mortality was carried out at the hospital. The study evaluated all surgical procedures for the past 5 years, starting from April 1, 2010 to March 31, 2015.

The researchers found that after adjustment for age and American Society of Anaesthesiologists overall risk scores, the patients operated in the night were 2.17 times more likely to die than those operating on during regular daytime working hours, and patients operated on in the late day were 1.43 times more likely to die than those operated on during regular daytime working hours.

The researchers say that theoretical possible causes include, but are not limited to, provider fatigue during anaesthesia and surgery, overnight hospital staffing issues, delays in treatment, or the patient being too sick to be postponed prior to treatment. The authors say: “Analysis of each of these possibilities is important to understand the reasons for this increased mortality and to direct any remedial action in an effort to reduce postoperative mortality.”

Source: World Federation of Societies of Anaesthesiologists