Does surgeon workload per day affect outcomes after pulmonary lobectomies?

Mathew Thomas, Mark S. Allen, Dennis A Wigle, K. Robert Shen, Stephen D. Cassivi, Francis C. Nichols, Claude Deschamps

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Our aim was to evaluate whether the workload of a surgeon, including number of operations, operative time, or number of rooms per day, influenced patient morbidity or mortality after pulmonary lobectomy. The records of all patients who underwent pulmonary lobectomy at our institution during 2 years (20072009) by 6 surgeons were retrospectively reviewed. Surgeon workload per day and individual patient variables were evaluated. Both univariate and multivariate analyses were performed to identify risk factors for patient morbidity and mortality. We analyzed 481 patients (269 men, 112 women) whose median age was 68 years (range, 20 to 94 years). Operative mortality occurred in 6 patients (1.25%), and morbidity occurred in 198 patients (41%). On univariate analysis, the total number of hours a surgeon operated per day was a significant predictor of complications (odds ratio, 1.032; p = 0. 048) and length of stay (average increase of 0.17 days for each additional hour; p = 0.004). There were multiple patient variables that were significant predictors of outcome. On multivariate analysis, which adjusted for patient variables, the total number of hours a surgeon operated per day remained a significant predictor of complications (odds ratio, 1.036; p = 0.03) and increased length of stay (average increase of 0.16 days for each additional hour; p = 0.006). On multivariate analysis, patient variables of age, forced expiratory volume In 1 second, and renal failure were significant predictors of outcome. The total number of hours a surgeon operates per day is independently associated with an increased risk of complications when performing pulmonary lobectomies. This could be related to surgeon fatigue associated with longer operative days. However, other patient variables are also associated with outcome. The relationship among these factors needs to be better understood with larger-scale models on a multiinstitutional level.

Original languageEnglish (US)
Pages (from-to)966-972
Number of pages7
JournalAnnals of Thoracic Surgery
Volume94
Issue number3
DOIs
StatePublished - Sep 2012

Fingerprint

Workload
Lung
Multivariate Analysis
Morbidity
Mortality
Length of Stay
Surgeons
Odds Ratio
Forced Expiratory Volume
Operative Time
Renal Insufficiency
Fatigue

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

Thomas, M., Allen, M. S., Wigle, D. A., Shen, K. R., Cassivi, S. D., Nichols, F. C., & Deschamps, C. (2012). Does surgeon workload per day affect outcomes after pulmonary lobectomies? Annals of Thoracic Surgery, 94(3), 966-972. https://doi.org/10.1016/j.athoracsur.2012.04.099

Does surgeon workload per day affect outcomes after pulmonary lobectomies? / Thomas, Mathew; Allen, Mark S.; Wigle, Dennis A; Shen, K. Robert; Cassivi, Stephen D.; Nichols, Francis C.; Deschamps, Claude.

In: Annals of Thoracic Surgery, Vol. 94, No. 3, 09.2012, p. 966-972.

Research output: Contribution to journalArticle

Thomas, M, Allen, MS, Wigle, DA, Shen, KR, Cassivi, SD, Nichols, FC & Deschamps, C 2012, 'Does surgeon workload per day affect outcomes after pulmonary lobectomies?', Annals of Thoracic Surgery, vol. 94, no. 3, pp. 966-972. https://doi.org/10.1016/j.athoracsur.2012.04.099
Thomas, Mathew ; Allen, Mark S. ; Wigle, Dennis A ; Shen, K. Robert ; Cassivi, Stephen D. ; Nichols, Francis C. ; Deschamps, Claude. / Does surgeon workload per day affect outcomes after pulmonary lobectomies?. In: Annals of Thoracic Surgery. 2012 ; Vol. 94, No. 3. pp. 966-972.
@article{554aa5d1df604712b83416459149898c,
title = "Does surgeon workload per day affect outcomes after pulmonary lobectomies?",
abstract = "Our aim was to evaluate whether the workload of a surgeon, including number of operations, operative time, or number of rooms per day, influenced patient morbidity or mortality after pulmonary lobectomy. The records of all patients who underwent pulmonary lobectomy at our institution during 2 years (20072009) by 6 surgeons were retrospectively reviewed. Surgeon workload per day and individual patient variables were evaluated. Both univariate and multivariate analyses were performed to identify risk factors for patient morbidity and mortality. We analyzed 481 patients (269 men, 112 women) whose median age was 68 years (range, 20 to 94 years). Operative mortality occurred in 6 patients (1.25{\%}), and morbidity occurred in 198 patients (41{\%}). On univariate analysis, the total number of hours a surgeon operated per day was a significant predictor of complications (odds ratio, 1.032; p = 0. 048) and length of stay (average increase of 0.17 days for each additional hour; p = 0.004). There were multiple patient variables that were significant predictors of outcome. On multivariate analysis, which adjusted for patient variables, the total number of hours a surgeon operated per day remained a significant predictor of complications (odds ratio, 1.036; p = 0.03) and increased length of stay (average increase of 0.16 days for each additional hour; p = 0.006). On multivariate analysis, patient variables of age, forced expiratory volume In 1 second, and renal failure were significant predictors of outcome. The total number of hours a surgeon operates per day is independently associated with an increased risk of complications when performing pulmonary lobectomies. This could be related to surgeon fatigue associated with longer operative days. However, other patient variables are also associated with outcome. The relationship among these factors needs to be better understood with larger-scale models on a multiinstitutional level.",
author = "Mathew Thomas and Allen, {Mark S.} and Wigle, {Dennis A} and Shen, {K. Robert} and Cassivi, {Stephen D.} and Nichols, {Francis C.} and Claude Deschamps",
year = "2012",
month = "9",
doi = "10.1016/j.athoracsur.2012.04.099",
language = "English (US)",
volume = "94",
pages = "966--972",
journal = "Annals of Thoracic Surgery",
issn = "0003-4975",
publisher = "Elsevier USA",
number = "3",

}

TY - JOUR

T1 - Does surgeon workload per day affect outcomes after pulmonary lobectomies?

AU - Thomas, Mathew

AU - Allen, Mark S.

AU - Wigle, Dennis A

AU - Shen, K. Robert

AU - Cassivi, Stephen D.

AU - Nichols, Francis C.

AU - Deschamps, Claude

PY - 2012/9

Y1 - 2012/9

N2 - Our aim was to evaluate whether the workload of a surgeon, including number of operations, operative time, or number of rooms per day, influenced patient morbidity or mortality after pulmonary lobectomy. The records of all patients who underwent pulmonary lobectomy at our institution during 2 years (20072009) by 6 surgeons were retrospectively reviewed. Surgeon workload per day and individual patient variables were evaluated. Both univariate and multivariate analyses were performed to identify risk factors for patient morbidity and mortality. We analyzed 481 patients (269 men, 112 women) whose median age was 68 years (range, 20 to 94 years). Operative mortality occurred in 6 patients (1.25%), and morbidity occurred in 198 patients (41%). On univariate analysis, the total number of hours a surgeon operated per day was a significant predictor of complications (odds ratio, 1.032; p = 0. 048) and length of stay (average increase of 0.17 days for each additional hour; p = 0.004). There were multiple patient variables that were significant predictors of outcome. On multivariate analysis, which adjusted for patient variables, the total number of hours a surgeon operated per day remained a significant predictor of complications (odds ratio, 1.036; p = 0.03) and increased length of stay (average increase of 0.16 days for each additional hour; p = 0.006). On multivariate analysis, patient variables of age, forced expiratory volume In 1 second, and renal failure were significant predictors of outcome. The total number of hours a surgeon operates per day is independently associated with an increased risk of complications when performing pulmonary lobectomies. This could be related to surgeon fatigue associated with longer operative days. However, other patient variables are also associated with outcome. The relationship among these factors needs to be better understood with larger-scale models on a multiinstitutional level.

AB - Our aim was to evaluate whether the workload of a surgeon, including number of operations, operative time, or number of rooms per day, influenced patient morbidity or mortality after pulmonary lobectomy. The records of all patients who underwent pulmonary lobectomy at our institution during 2 years (20072009) by 6 surgeons were retrospectively reviewed. Surgeon workload per day and individual patient variables were evaluated. Both univariate and multivariate analyses were performed to identify risk factors for patient morbidity and mortality. We analyzed 481 patients (269 men, 112 women) whose median age was 68 years (range, 20 to 94 years). Operative mortality occurred in 6 patients (1.25%), and morbidity occurred in 198 patients (41%). On univariate analysis, the total number of hours a surgeon operated per day was a significant predictor of complications (odds ratio, 1.032; p = 0. 048) and length of stay (average increase of 0.17 days for each additional hour; p = 0.004). There were multiple patient variables that were significant predictors of outcome. On multivariate analysis, which adjusted for patient variables, the total number of hours a surgeon operated per day remained a significant predictor of complications (odds ratio, 1.036; p = 0.03) and increased length of stay (average increase of 0.16 days for each additional hour; p = 0.006). On multivariate analysis, patient variables of age, forced expiratory volume In 1 second, and renal failure were significant predictors of outcome. The total number of hours a surgeon operates per day is independently associated with an increased risk of complications when performing pulmonary lobectomies. This could be related to surgeon fatigue associated with longer operative days. However, other patient variables are also associated with outcome. The relationship among these factors needs to be better understood with larger-scale models on a multiinstitutional level.

UR - http://www.scopus.com/inward/record.url?scp=84865270105&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84865270105&partnerID=8YFLogxK

U2 - 10.1016/j.athoracsur.2012.04.099

DO - 10.1016/j.athoracsur.2012.04.099

M3 - Article

VL - 94

SP - 966

EP - 972

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

IS - 3

ER -