New research that examined the 30-day survival rate of patients who underwent surgeries at different times of the day suggests that patients are more likely to die as a result of the operation if it takes place at night as opposed to surgeries performed during regular daytime hours.
The results were based on the 30-day survival rates for patients at a hospital in Canada between 2010 and 2015. Researchers noted that 41,716 emergency and routine operations were performed on 33,942 people during that period. The operations were classified as taking place during the day (7:30 am – 3:29 pm), during the evening (3:30 pm – 11:29 pm) or at night (11:30 pm – 7:29 am).
After looking at the data, researchers found that when accounting all applicable factors, patients operated on in the night were 2.17 times more likely to die than those operated on during the daytime hours. Patients operated on during the evening were 1.43 times more likely to die than those operated on during the daytime hours.
How Reliable Are These Findings?
Researchers say there are a number of reasons why the mortality rates more than double at night, and they all place the onus on the medical team. They suggested fatigue among the medical staff, overnight staffing shortages and treatment delays.
“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.”
However, there are a number of factors that are overlooked or just outright ignored. Not surprisingly, some doctors challenged the validity of the study suggesting a number of other factors that might influence why surgery at night has a higher mortality rate:
- Elective surgeries are rarely performed after daytime hours, meaning surgeries after hours are typically more high-risk or serious.
- Since more routine surgeries are typically performed during the day, it drives down the likelihood of mortality during these operations.
- Other surgeons suggest that people who come in after hours are more likely to be dealing with serious trauma or worse symptoms, and they need attention right away.
- Unavailability of surgeons to perform these operations as quickly as necessary. This is not to say that surgeons are ignoring their patients in need, but if a gastric operation runs a little longer than expected, the patient who came in at 6 p.m. with appendix pain may not have immediate access to surgery, increasing their mortality risk when they finally do get under the knife.
It should come as no surprise that higher-risk operations performed after normal business hours have higher mortality rates. A better study would be to compare the mortality rates of precise operations performed at certain hours of the day.