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<p> <em>A new study finds little difference in outcomes when physicians had worked overnight or been off. Here are the details.</em></p>

A Good Night’s Sleep is Not Always Necessary

By Brenda Mooney, Special to AHC Media

TORONTO – Having to do a procedure after a late night at work might be a bit daunting, but chances are you’ll do better than you fear.

Research published recently in the New England Journal of Medicine didn’t find significant difference in the performance of physicians who were well rested compared to those who were fatigued.

A study led by researchers from the University of Toronto examined the effectiveness of practitioners who had provided medical care after midnight and then performed elective procedures later that day.

To do so, the study team matched patients undergoing 1 of 12 elective daytime procedures performed by a physician who had treated patients from midnight to 7 a.m. to patients undergoing the same procedure by the same physician when he or she had not worked the midnight to 7 a.m. shift. Measured outcomes of the study, which included 38,978 patients treated by 1,448 physicians, included death, readmission, complications, length of stay, and procedure duration.

“Sleep deprivation and fatigue may have effects on physician performance. However, in this population-based study, we found no significant difference in short-term outcomes for patients treated by a physician who had performed overnight clinical work, as compared with patients treated by the same physician but after a night when no clinical work had been performed,” the study authors report. “The results were consistent across a wide range of procedures and physician characteristics and in academic and nonacademic institutions.”

No significant differences were found in any of the primary outcomes nor with the type of center, age of physicians or category of procedure. In addition, secondary analyses revealed no notable variation between patient groups in length of stay or procedure duration.

“Overall, the risks of adverse outcomes of elective daytime procedures were similar whether or not the physician had provided medical services the previous night,” the study concludes.