Need surgery? Should you avoid your surgeon’s birthday? – . Health Blog

If you do need surgery, you should be sure that researchers have been studying factors that predict the success or failure of an operation for years. Some of the key results were the ones you might expect.

For example, studies have shown that hospitals and medical centers that perform many hip and knee replacements tend to have lower complication rates than hospitals that perform fewer surgeries. As a result, there is a trend for people in need of these surgeries to be performed in high volume centers. Similarly, surgeons who perform hip or knee replacement surgeries frequently tend to achieve better results than surgeons who do them infrequently. Studies like this have been published for a number of other surgeries and conditions.

Less obvious factors to consider when planning operations

You might be surprised to learn that less obvious factors have also been investigated. For example, researchers have investigated whether

  • Surgical outcomes are worse in teaching hospitals in July when new medical and surgical trainees start (a phenomenon known as the “July Effect”). The results are mixed: some studies find it true and others debunk the idea.
  • Music played in the operating room – including loud or soft, classy or upbeat, or no music at all – is helpful or harmful. Again, the evidence is mixed.
  • Surgical success can vary depending on your surgeon's dominant hand. In a study of cataract surgery, patients operated on by left-handed trainee surgeons had fewer complications than patients operated on by right-handed trainees.

Another surprising surgical study: birthdays

A new study published in the medical journal The BMJ tried to answer a question I would never have thought of: If a surgeon performs an operation on his birthday, does it affect his patient's chances of survival?

Let's aside for a moment why these researchers thought this was a worthy research question, and let's look at how the study was conducted and what the researchers found. They analyzed survival data from nearly one million emergency surgeries performed by more than 47,000 surgeons in the United States between 2011 and 2014. All patients were at least 65 years old and had one of 17 common emergency operations such as B. Coronary artery bypass surgery or gallbladder removal. While emergency surgery is not planned, depending on the situation, it may not need to be performed on the day of diagnosis.

The study found that more patients died within one month of surgery when the surgery was performed on the surgeon's birthday (6.9%) than on other days of the year (5.6%). The difference was statistically significant and did not appear to be due to any alternative explanation the researchers could identify, such as whether

  • The surgery dates were postponed sooner or later due to the surgeon's birthday
  • A small number of surgeons may have had high complication rates that could skew results
  • There were differences in surgical complexity, frequency, or type
  • Surgeons may have purposely avoided having an operation on her birthday
  • The birthdays were “big” (e.g. 60 years old) or fell on a weekend.

Statistical methods have been used to reduce or eliminate the potential impact of each of these possible explanations. Interestingly, in planned (non-emergency) operations, no effect of the surgeon's birthday was found.

Why does surgical success depend on whether it is the surgeon's birthday?

It is fair to ask if there is a plausible explanation for how a surgeon's birthday could affect surgical success.

The study's authors suggest that the results show how "surgeons might be distracted by life events". But what does that mean? Were the surgeons less focused? Did you rush the operation to get home early and celebrate? Has the excitement of her birthday affected the physical performance of the operation in any way? All of these possible explanations (and perhaps others you might suggest) are speculative, as the study didn't focus on why the results were observed.

The final result

It is tempting to dismiss the results of this study as "don't believe everything you read". After all, it is only a study, and there is no convincing or obvious way to explain the results. And it seems impractical for a person in need of emergency surgery to find out what their surgeon's birthday is, and if it is the day of the surgery, ask for another surgeon.

On the other hand, the case could be cited that emergency doctors' on-call plans should be adjusted until we know more in order to avoid tasks on a surgeon's birthday. Patients could get modestly better results, and the surgeon could have something very special on his birthday: a day off from surgery.

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