Does surgery performed at night time shifts lead to a worse outcome? Findings from Asir Central Hospital

Abstract

Background: Night shifts, prolonged work hours and insufficient recovery sleep hours mainly affect the homeostatic and circadian processes which influence the physician performance, resulting in more medical errors, failure due to poor attention, and work-related wounds. This study was done to evaluate the differences in outcomes between night time and daytime surgeries. Methodology: This was a retrospective cohort study on 500 patients, with age range of 15 to 75 years or older, done from 2015 – 2018 in Asir hospital, Saudi Arabia. A comparison was performed of operations completed between daytime versus those between nighttime, and also between those which were completed between weekday and weekend. The data were conducted based on the database of the Asir Hospital. Results: Most of the patients were males (61.7%). The Chi-square test between two times of surgery groups regarding different demographic characters reported significant correlations regarding the age of 75 years or more, male gender, comorbidity, gall bladder stone and obstruction injury type, non-occurrence of injury, gall bladder stone as a mechanism of injury, while laparoscopy, and laparotomy in surgery types. Significant correlations were also reported with 15-24 years old group, diabetes mellitus, and comorbid cardiac disorders, non-occurrence of injury, gall bladder stone as a mechanism of injury and bleeding complications regarding the day of surgery. Conclusion: It is critical to maximize patient safety and provide the best possible care for patients at any time of the day. This includes surgeon self-awareness and carefully choosing when to operate.