Last Updated: 2009-10-14 18:45:10 -0400 (Reuters Health)
Procedures performed by physicians during the day after an overnight shift do not have a higher rate of complications, as long as the physician has had at least a six-hour chance for sleep.
Physicians who fail to get at least a "six-hour sleep opportunity" before returning to work do make more errors, according to a study by Dr. Jeffrey M. Rothschild and associates from Brigham and Women’s Hospital in Boston.
In the Journal of the American Medical Association for October 14, the researchers report on 86 surgeons and 134 obstetricians who were involved in overnight and early morning emergency surgeries and deliveries prior to a daytime procedure. As many as 5 control procedures were identified for each nighttime procedure.
A total of 919 surgical and 957 obstetrical cases were matched with 3552 and 3945 control procedures. In general, complication rates for procedures performed after having worked during the night before were not significantly different than in control procedures.
On the other hand, the rate of complications was nearly doubled compared with controls when physicians did not have a six-hour sleep opportunity before returning to work (odds ratio 1.72, p = 0.04).
Dr. Rothschild and associates urge that "for situations in which it is necessary for attending physicians to conduct life-saving procedures following overnight work, effective strategies to minimize the effects of fatigue should be adopted into practice."
JAMA 2009;302:1565-1572.
