Prospective Evaluation of Consultant Surgeon Sleep Deprivation and Outcomes in More Than 4000 Consecutive Cardiac Surgical Procedures

Chu, Michael; Stitt, Larry; Fox, Stephanie A.; Kiaii, Bob; Quantz, Mackenzie; Guo, Lina; Myers, Mary Lee; Hewitt, J C; Novick, Richard J.

doi:10.1001/archsurg.2011.121

Cited by 58 publications

(47 citation statements)

References 34 publications

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“…Previous studies, that focused on various surgical procedures, found no association between sleep deprivation and surgical outcomes or complications [28–31]. In contrast to a routine clinical procedure, such as blood drawing, surgical procedures require considerable attention and concentration, which help to overcome the feeling of fatigue and sleepiness due to night duty.…”

Section: Discussionmentioning

confidence: 99%

Night duty and decreased brain activity of medical residents: a wearable optical topography study

Nishida

Kikuchi

Miwakeichi

et al. 2017

Medical Education Online

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Background: Overwork, fatigue, and sleep deprivation due to night duty are likely to be detrimental to the performance of medical residents and can consequently affect patient safety. Objective: The aim of this study was to determine the possibility of deterioration of cerebral function of sleep-deprived, fatigued residents using neuroimaging techniques. Design: Six medical residents were instructed to draw blood from artificial vessels installed on the arm of a normal cooperator. Blood was drawn at a similar time of the day, before and after night duty. To assess sleep conditions during night duty, the participants wore actigraphy units throughout the period of night duty. Changes in cerebral hemodynamics, during the course of drawing blood, were measured using a wearable optical topography system. Results: The visual analogue scale scores after night duty correlated negatively with sleep efficiency during the night duty (ρ = −0.812, p = 0.050). The right prefrontal cortex activity was significantly decreased in the second trial after night duty compared with the first (p = 0.028). The extent of [oxy-Hb] decrease, indicating decreased activity, in the right dorsolateral prefrontal cortex correlated negatively with the Epworth sleepiness score after night duty (ρ = −0.841, p = 0.036). Conclusions: Sleep deprivation and fatigue after night duty, caused a decrease in the activity of the right dorsolateral prefrontal cortex of the residents, even with a relatively easy routine. This result implies that the brain activity of medical residents exposed to stress on night duty, although not substantially sleep-deprived, was impaired after the night duty, even though they apparently performed a simple medical technique appropriately. Reconsideration of the shift assignments of medical residents is strongly advised. Abbreviations: DLPFC: Dorsolateral prefrontal cortex; ESS: Epworth sleepiness scale; PSQI: Pittsburgh sleep quality index; ROI: Regions of interest; VAS: Visual analogue scale; WOT: Wearable optical topography

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Section: Discussionmentioning

confidence: 99%

Night duty and decreased brain activity of medical residents: a wearable optical topography study

Nishida

Kikuchi

Miwakeichi

et al. 2017

Medical Education Online

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show abstract

“…Of 4047 consecutive procedures performed by six surgeons, there was no significant interaction between hours of sleep and outcomes [19]. The authors hypothesized that well developed compensatory mechanisms must develop in cardiac surgeons to combat the effect of SD.…”

Section: What Is Happening In the Context Of Cardiothoracic Surgery?mentioning

confidence: 99%

Sleep deprivation leads to burnout and cardiothoracic surgeons have to deal with its consequences

Jarral

Baig

Shetty

et al. 2015

International Journal of Cardiology

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“…The authors themselves acknowledge that they did not know whether or not the surgeons had slept the entire night prior to the “control” cases when they were not on call, and that there were potential confounders created by the retrospective nature of the study. On the other extreme are the findings of a more recent paper by Chu et al[68] in which the authors evaluated the effects of sleep deprivation on the outcome of more than 4000 consecutive cardiac surgical procedures and found no difference at all in the results with sleep deprivation of the kind we are discussing today. In between these two extremes there are other studies that have focused on the effect of reduction of resident work hours and workload of surgeons, etc., with varying results and many of these studies showing no effect on the outcome of patients.…”

Section: Conmentioning

confidence: 95%

Should Sleep-Deprived Surgeons Be Prohibited From Operating Without Patients' Consent?

Czeisler

Sade

2013

The Annals of Thoracic Surgery

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Prospective Evaluation of Consultant Surgeon Sleep Deprivation and Outcomes in More Than 4000 Consecutive Cardiac Surgical Procedures

Cited by 58 publications

References 34 publications

Night duty and decreased brain activity of medical residents: a wearable optical topography study

Night duty and decreased brain activity of medical residents: a wearable optical topography study

Sleep deprivation leads to burnout and cardiothoracic surgeons have to deal with its consequences

Should Sleep-Deprived Surgeons Be Prohibited From Operating Without Patients' Consent?

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