{"id":8274,"date":"2011-05-16T16:00:17","date_gmt":"2011-05-16T20:00:17","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?p=8274"},"modified":"2011-07-19T17:44:25","modified_gmt":"2011-07-19T21:44:25","slug":"sleep-deprivation-not-as-bad-as-we-think-for-cardiac-surgeons","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2011\/05\/16\/sleep-deprivation-not-as-bad-as-we-think-for-cardiac-surgeons\/","title":{"rendered":"Sleep Deprivation Not as Bad as We Think for Cardiac Surgeons"},"content":{"rendered":"<p>Sleep deprivation in cardiac surgeons does not lead to worse surgical outcomes, according to <a href=\"http:\/\/archsurg.ama-assn.org\/cgi\/content\/short\/archsurg.2011.121\">a study published in the <em>Archives of Surgery<\/em><\/a>. Michael Chu and colleagues collected sleep information from six consultant surgeons working at a large hospital in Ontario, Canada and outcome data from their 4,047 patients who underwent cardiac surgery from 2004 through 2009.<\/p>\n<p>Of the 4,407 procedures:<\/p>\n<ul>\n<li>83 were performed by a surgeon with 0 to 3 hours of sleep<\/li>\n<li>1595 with 3 to 6 hours<\/li>\n<li>2369 with more than 6 hours<\/li>\n<\/ul>\n<p>Mortality and major complications did not differ significantly across the groups:<\/p>\n<ul>\n<li>Mortality: 3.6% in the 0-3 hour group, 2.8% in the 3-6 hour group, and 3.4% in the 6+ hour group (p=0.53)<\/li>\n<\/ul>\n<p>Observed versus expected ratio of major complications:<\/p>\n<ul>\n<li>1.20 in the 0-3 hour group, 0.95 in the 3-6 hour group, and 1.07 in the 6+ hour group (p=0.25)<\/li>\n<\/ul>\n<p>The researchers also found that the age of the surgeons did not significantly affect outcomes.<\/p>\n<p>The authors write that their findings &#8220;may have important ramifications in restricting current trainee work hours when future practice may demand optimal performance during sleep-deprived conditions.&#8221; Although the ACGME has imposed limitations on work hours for medical trainees, the authors point to studies, including their own, that undermine &#8220;the intuitive belief that reduced work hours improves daytime fatigue, trainee performance, and, hence, patient safety&#8230;. the findings of our study might suggest reassessment of this belief when contemplating trainee work-hour limitations.&#8221;<\/p>\n<p>In <a href=\"http:\/\/archsurg.ama-assn.org\/cgi\/content\/short\/archsurg.2011.120\">an invited critique<\/a>, David Yuh writes that the &#8220;reassuring&#8221; results of the study &#8220;may not be reflected in future generations of cardiac surgeons&#8221; because under new regulations, surgical trainees may not &#8220;enjoy the purported benefits of comparatively long hours, including physiologic and mental conditioning and following the course of an acute disease process from beginning to end.&#8221; He asks:<\/p>\n<p style=\"padding-left: 30px;\">&#8220;Will patient safety be paradoxically compromised by young practicing cardiac surgeons who can more easily convince themselves that delaying the coronary revascularization of an ischemic patient or repair of an acute ascending aortic dissection for a few hours of extra sleep will actually improve their technical or cognitive performance and therefore serve the best interests of the patient?&#8221;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Sleep deprivation in cardiac surgeons does not lead to worse surgical outcomes, according to a study published in the Archives of Surgery. Michael Chu and colleagues collected sleep information from six consultant surgeons working at a large hospital in Ontario, Canada and outcome data from their 4,047 patients who underwent cardiac surgery from 2004 through [&hellip;]<\/p>\n","protected":false},"author":196,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[20],"tags":[842,843],"class_list":["post-8274","post","type-post","status-publish","format-standard","hentry","category-cardiac-surgery","tag-sleep-deprivation","tag-work-hours"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/8274","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/196"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=8274"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/8274\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=8274"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=8274"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=8274"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}