The sleepy surgeon: Does night-time surgery for trauma affect mortality outcomes?

Syed N. Zafar, Laura Libuit, Zain G. Hashmi, Kakra Hughes, Wendy R. Greene, Edward E. Cornwell, Adil H. Haider, Terrence M. Fullum, Daniel D. Tran

Research output: Contribution to journalArticlepeer-review

30 Citations (Scopus)


Background Sleepiness and fatigue affect surgical outcomes. We wished to determine the association between time of day and outcomes following surgery for trauma. Methods From the National Trauma Data Bank (2007 to 2010), we analyzed all adults who underwent an exploratory laparotomy between midnight and 6 am or between 7 am and 5 pm. We compared hospital mortality between these groups using multivariate logistic regression. Additionally, for each hour, a standardized mortality ratio was calculated. Results About 16,096 patients and 15,109 patients were operated on in the night time and day time, respectively. No difference was found in the risk-adjusted mortality rate between the 2 time periods (odds ratio.97, 95% confidence interval.893 to 1.058). However, hourly variations in mortality during the 24-hour period were noted. Conclusion Trauma surgery during the odd hours of the night did not have an increased risk-adjusted mortality when compared with surgery during the day.

Original languageEnglish
Pages (from-to)633-639
Number of pages7
JournalAmerican Journal of Surgery
Issue number4
Publication statusPublished - 1 Apr 2015
Externally publishedYes


  • Fatigue
  • Mortality
  • Trauma surgery
  • Work hours


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