A Bad Time to Have Surgery?

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The most recent edition of The Atlantic offers an interesting look at the possible correlation between surgical errors and the time during which the surgery is performed. While there’s no conclusive evidence, the article does point out some research that warrants a consideration. “Which is not to say that the calendar doesn’t make a difference: people admitted to the hospital on an emergency basis on public holidays are, compared with patients admitted on non-holidays, 48 percent more likely to be dead one week later. The clock matters, too: with each hour that passes on a given day of performing colonoscopies, the average gastroenterologist is 4.6 percent less likely to detect a colon polyp. Similarly, in a study of surgeries at Duke University Medical Center, the likelihood of problems related to anesthesia increased from a low of 1 percent during surgeries starting at 9 a.m. to a high of 4.2 percent for those starting at 4 p.m., possibly because practitioners grew tired over the course of the day. Timing might even influence whether you have surgery: the economist H. Shelton Brown III once described a “rush hour effect,” whereby women in labor were more likely to have an unplanned C‑section on Friday between 3 and 9 p.m.—perhaps, he suggested, doctors were interested in getting things wrapped up before the weekend (those “things” being infants). Night is not the ideal time to be in labor, either. One California study found a 25 percent greater risk of neonatal death following nighttime deliveries. Some of that increased risk could have been because nighttime hospitalizations disproportionately involve emergencies and other complications. But even controlling for such factors, infant death was 16 percent more likely following a late-night birth.”

Kevin Dugan
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