Tired Doctors More Prone to Errors

Long shifts, little sleep raise complication rate for practicing physicians, study finds

By Steven Reinberg
HealthDay Reporter

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TUESDAY, Oct. 13 (HealthDay News) -- Attending surgeons and obstetricians/gynecologists who get fewer than six hours of sleep between procedures risk increasing the rate of surgical complications, according to Harvard researchers.

A lot of attention has been paid to the long hours that residents and interns work and the increase in medical errors brought on by their fatigue, but the new study found the same problems among practicing physicians.

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"Attending surgeons and obstetricians/gynecologists, like resident physicians and nurses, are vulnerable to the effects of fatigue and extended work shifts on performance and patient care," said Dr. Jeffrey M. Rothschild, a physician at Brigham and Women's Hospital in Boston and the lead researcher on the study.

"The risk of performing post-nighttime cases without sufficient rest may be especially important in hospitals without backup support or house staff physicians to assist a fatigued attending physician," he added.

The report is published in the Oct. 14 issue of the Journal of the American Medical Association.

For the study, Rothschild's group assessed how working at night and sleep affected the rate of surgical complications in procedures done the next day. Specifically, they looked at the 919 surgical and 957 obstetrical procedures done the day after a doctor had worked at night and compared them with 3,552 surgical and 3,945 obstetrical procedures done without preceding night work.

When doctors worked overnight but still had sufficient sleep, there was not a significantly increased risk for complications on procedures performed the next day, Rothschild said.

"However, if the opportunity for sleep prior to the post-nighttime procedure was less than six hours, there was a 2.7-fold greater risk of procedural complications, such as infection, wound failure and bleeding," he said. The study also found a higher rate of complications when procedures were performed after a doctor had worked a shift of more than 12 hours, although Rothschild said the rate increase was not statistically significant.

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