Beautiful Virgin Islands

Saturday, Jul 05, 2025

Elderly patients 23% more likely to die if their emergency surgery takes place on the surgeon's birthday

Elderly patients 23% more likely to die if their emergency surgery takes place on the surgeon's birthday

New study finds elderly patients whose emergency surgery took place on the surgeon's birthday were 23% more likely to die within a month.

A new study has found that elderly patients who underwent emergency surgery on their surgeon’s birthday had significantly higher 30-day mortality rates than patients whose surgery took place on any other day of the year.

The 30-day mortality rate (defined as death within 30 days after surgery) for the “surgeon’s birthday” group was 6.9%. This was 23% higher than the 5.6% rate for the “other day” group.

The study, which appears today in the British Medical Journal (BMJ), looked at 980,876 procedures performed in US hospitals by 47,489 surgeons. Of those procedures, 2,064 (0.2%) took place on a surgeon’s birthday. The patients were all Medicare beneficiaries aged 65 to 99. They had all undergone one of 17 common emergency surgical procedures between 2011 and 2014.

Distractions during the most common emergency surgery types


Examples of those 17 procedures included cardiovascular surgeries, hip and femur fracture, appendectomy, and small bowel resection. The study focused on emergency surgery, so as to minimize the potential selection bias. For example, surgeons might otherwise choose patients based on their illness severity, or patients might choose their surgeon.

As the authors write, “The effect size of surgeons’ birthday observed in our analysis (1.3 percentage point increase or a 23% increase in mortality), though substantial, is comparable to the impact of other events, including holidays (e.g., Christmas and New Year) and weekends.”

In fact, the history of surgery has often demonstrated that external factors can influence surgical outcomes. The authors refer to a 2014 study showing that patients admitted to Scottish emergency rooms on public holidays had a 27% increase in 30-day mortality. Other research has found, for example, that doctors are more likely to prescribe antibiotics and opioids — and less likely to order cancer screening tests — as the workday progresses. This is most likely because the “cumulative cognitive demand” of such decisions gradually takes its toll.

Research on judges has yielded similar results. It has found, for example, that external factors as diverse as outdoor temperatures and sports results can influence judges’ decisions.

A natural experiment: ER surgery on the doctor’s birthday


But the authors say the “natural experiment” in the present study is more revealing than, for example, holiday-related mortality rates. That is because “those events not only affect physicians’ performance but also influence patients’ decision to seek care (i.e., patients seeking care on these special days might be sicker than those seeking care on other days), as well as hospital staffing.” Unless, of course, the patients know their surgeon’s birthday, which is unlikely (though that may change if this study becomes widely known).

The 1.3% effect size was the result after a very through series of controls. These included, for example, excluding those surgeons with the highest patient mortality rates. Other controls included assigning a random “pseudo-birthday” to surgeons to see whether the results still held up, or checking whether the surgeon did an above-average number of procedures on their birthday.

Likewise, the researchers controlled for “milestone” birthdays (such as 40 or 50), and whether a birthday fell on a Friday (which might make after-work birthday festivities more likely). Their findings also held up when the analysis was restricted to procedures with the highest average mortality, or to only the most ill patients. In fact, without these adjustments, the 30-day mortality rate difference between the birthday and non-birthday groups (the unadjusted rate) was even higher (7.0% vs. 5.6%, or a 1.4% difference).

Why does emergency surgery suffer on surgeon’s birthday?


The authors propose a few potential explanations for this “birthday effect.”

These include hurrying through an emergency surgery to be on time for after-work birthday events; distracting birthday-related phone calls or text messages; more conversations with well-wishing staff members; and a decreased likelihood to go back to the hospital that evening if a patient’s condition deteriorates.

They also found that some surgeons did not work on their birthdays. The surgeons in this study performed 2,144 procedures one day before their birthday, and 2,027 one day after their birthday. But they only 1,805 surgeons procedures on their birthday itself. This does not affect the results of the study’s analyses. But it does suggest “that birthdays are an important enough factor for some surgeons to choose not to operate on that day, which supports the credibility of our assumption that a birthday could be a distracting factor for those surgeons who choose to operate on that day,” the authors write.

Limitations and future directions


The researchers emphasized that this study focused on common procedures, and on older Medicare patients. This means that the findings may not apply to other types of patients, or to other surgical procedures.

Still, the authors write, these results may lead to “additional support for surgeons who have potentially distracting events,” such as birthdays, “to make sure that patients receive high quality surgical care regardless of when undergo surgery.”

Newsletter

Related Articles

Beautiful Virgin Islands
0:00
0:00
Close
Trump Celebrates Independence Day with B-2 Flyover and Signs Controversial Legislation
Boris Johnson Urges Conservatives to Ignore Farage
SNP Ordered to Update Single-Sex Space Guidance Within Days
Starmer Set to Reject Calls for Wealth Taxes
Stolen Century-Old Rolls-Royce Recovered After Hotel Theft
Macron Presses Starmer to Recognise Palestinian State
Labour Delayed Palestine Action Ban Over Riot Concerns
Swinney’s Tax Comments ‘Offensive to Scots’, Say Tories
High Street Retailers to Enforce Bans on Serial Shoplifters
Music Banned by Henry VIII to Be Performed After 500 Years
Steve Coogan Says Working Class Is Being ‘Ethnically Cleansed’
Home Office Admits Uncertainty Over Visa Overstayer Numbers
JD Vance Questions Mandelson Over Reform Party’s Rising Popularity
Macron to Receive Windsor Carriage Ride in Royal Gesture
Labour Accused of ‘Hammering’ Scots During First Year in Power
BBC Head of Music Stood Down Amid Bob Vylan Controversy
Corbyn Eyes Hard-Left Challenge to Starmer’s Leadership
London Tube Trains Suspended After Major Fire Erupts Nearby
Richard Kemp: I Felt Safer in Israel Under Attack Than in the UK
Cyclist Says Police Cited Human Rights Act for Riding No-Handed
China’s Central Bank Consults European Peers on Low-Rate Strategies
AI Raises Alarms Over Long-Term Job Security
Saudi Arabia Maintains Ties with Iran Despite Israel Conflict
Musk Battles to Protect Tesla Amid Trump Policy Threats
Air France-KLM Acquires Majority Stake in Scandinavian Airlines
UK Educators Sound Alarm on Declining Child Literacy
Shein Fined €40 Million in France Over Misleading Discounts
Brazil’s Lula Visits Kirchner During Argentina House Arrest
Trump Scores Legislative Win as House Passes Tax Reform Bill
Keir Starmer Faces Criticism After Rocky First Year in Power
DJI Launches Heavy-Duty Coaxial Quadcopter with 80 kg Lift Capacity
U.S. Senate Approves Major Legislation Dubbed the 'Big Beautiful Bill'
Largest Healthcare Fraud Takedown in U.S. History Announced by DOJ
Poland Implements Border Checks Amid Growing Migration Tensions
Political Dispute Escalates Between Trump and Musk
Emirates Airline Expands Market Share with New $20 Million Campaign
Amazon Reaches Milestone with Deployment of One Millionth Robot
US Senate Votes to Remove AI Regulation Moratorium from Domestic Policy Bill
Yulia Putintseva Calls for Spectator Ejection at Wimbledon Over Safety Concerns
Jury Deliberations in Diddy Trial Yield Partial Verdict in Serious Criminal Charges
House Oversight Committee Subpoenas Former Jill Biden Aide Amid Investigation into Alleged Concealment of President Biden's Cognitive Health
King Charles Plans Significant Role for Prince Harry in Coronation
Two Chinese Nationals Arrested for Espionage Activities Against U.S. Navy
Amazon Reaches Major Automation Milestone with Over One Million Robots
Extreme Heat Wave Sweeps Across Europe, Hitting Record Temperatures
Meta Announces Formation of Ambitious AI Unit, Meta Superintelligence Labs
Robots Compete in Football Tournament in China Amid Injuries
Trump Administration Considers Withdrawal of Funding for Hospitals Providing Gender Treatment to Minors
Texas Enacts Law Allowing Gold and Silver Transactions
China Unveils Miniature Insect-Like Surveillance Drone
×