美国加州大学洛杉矶分校Yusuke Tsugawa团队研究了在外科医师生日当天接受手术的患者的死亡率。2020年12月10日，该研究发表在《英国医学杂志》上。

为了确定外科医生在生日那天进行的手术与一年中其他日子相比，术后患者的死亡率是否有所不同，研究组在美国急诊和重症监护医院进行了一项回顾性观察研究。研究组招募了65-99岁、100％有偿付费医疗保险受益人，他们在2011-14年度接受了17种常见的紧急外科手术之一。主要结局为患者术后30天的死亡率。

研究组共分析了47489名外科医生施行的980876例手术。其中2064例（0.2％）手术是在外科医生的生日当天进行的。在外科医生生日那天接受手术的患者与其他日子接受手术的患者临床特征（包括疾病的严重程度）相差不大。

在手术外科医生的生日那天接受手术的患者未经校正的30天总死亡率为7.0％，而在其他日子手术的患者则为5.6％。在校正了患者特征和外科医生的固定效应（有效比较同一位外科医生在不同日期进行手术的患者的结局）后，在外科医生生日那天进行手术的患者的死亡率显著高于在其他日子进行手术的患者，校正后的死亡率分别为6.9％和5.6％。事件研究分析了手术日的病人死亡率与外科医生生日之间的相关性，发现了相似结局。

研究结果表明，对于接受常规紧急手术的医保受益人，在外科医生生日那天接受手术的患者的死亡风险显著高于其他日子接受手术的患者。

附：英文原文

Title: Patient mortality after surgery on the surgeon’s birthday: observational study

Author: Hirotaka Kato, Anupam B Jena, Yusuke Tsugawa

Issue&Volume: 2020/12/10

Abstract:

Objective To determine whether patient mortality after surgery differs between surgeries performed on surgeons’ birthdays compared with other days of the year.

Design Retrospective observational study.

Setting US acute care and critical access hospitals.

Participants 100% fee-for-service Medicare beneficiaries aged 65 to 99 years who underwent one of 17 common emergency surgical procedures in 2011-14.

Main outcome measures Patient postoperative 30 day mortality, defined as death within 30 days after surgery, with adjustment for patient characteristics and surgeon fixed effects.

Results 980876 procedures performed by 47489 surgeons were analyzed. 2064 (0.2%) of the procedures were performed on surgeons’ birthdays. Patient characteristics, including severity of illness, were similar between patients who underwent surgery on a surgeon’s birthday and those who underwent surgery on other days. The overall unadjusted 30 day mortality on the operating surgeon’s birthday was 7.0% (145/2064) and that on other days was 5.6% (54824/978812). After adjusting for patient characteristics and surgeon fixed effects (effectively comparing outcomes of patients treated by the same surgeon on different days), patients who underwent surgery on a surgeon’s birthday exhibited higher mortality compared with patients who underwent surgery on other days (adjusted mortality rate, 6.9% v 5.6%; adjusted difference 1.3%, 95% confidence interval 0.1% to 2.5%; P=0.03). Event study analysis of patient mortality by day of surgery relative to a surgeon’s birthday found similar results.

Conclusions Among Medicare beneficiaries who underwent common emergency surgeries, those who received surgery on the surgeon’s birthday experienced higher mortality compared with patients who underwent surgery on other days. These findings suggest that surgeons might be distracted by life events that are not directly related to work.

DOI: 10.1136/bmj.m4381

Source: https://www.bmj.com/content/371/bmj.m4381