Investigators from the University of Pennsylvania using a retrospective analysis of 144,740 operations done within the VA system demonstrated that morbidity, but not mortality, increases when non emergent general and vascular cases are started after 4 p.m. They concluded that when considering a nonemergent procedure, surgeons most bear in mind that cases starting after “routine business” hours may face an elevated risk of complications. Kelz RR et al: Time of day is associated with postoperative morbidity: an analysis of the National Surgical Quality Improvement Program Data. Ann Surg 2008;247:544-552
David S. Smith, M.D., Ph.D.