SynthesisThe British journal of surgery2024
Impact of fatigue in surgeons on performance and patient outcome: systematic review.
Synthesis in The British journal of surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 28 citations in OpenAlex.
- Healthcare workers' sustainable employability in relation to quality of care: an umbrella review.BMJ open · 2025Pooled it
- Clear Vision, Clear Savings: Enhancing Efficiency in Minimally Invasive Surgery.JSLS : Journal of the Society of Laparoendoscopic SurgeonsPooled it
- Impact of acute sleep deprivation on laparoscopic performance: a prospective, randomized crossover trial.Surgical endoscopy · 2026Trial
- Impact of a full clinical workday on surgical performance in simulated laparoscopy: a controlled crossover trial.BMC medical education · 2026Trial
- Acetabular-only robot-assisted total hip arthroplasty is associated with lower surgeon stress index and perceived workload than conventional total hip arthroplasty: a prospective comparative cohort study.Arthroplasty (London, England) · 2026Article
- Surgeon workload in supervised robotic colorectal surgery: a surgical task load index study.Surgical endoscopy · 2026Article
- Influence of the Surgeon's First Operation of the Day on Patient Outcomes.Annals of surgery · 2026Article
- Early clinical impact of mesenteric Kocherization in robotic pancreaticoduodenectomy: a propensity score-matched comparative study.Surgical endoscopy · 2026Article
- Association Between Surgical Timing and Perioperative Outcomes in Lumbar Spine Surgery: A Retrospective Cohort Study.Journal of clinical medicine · 2026Article
- Procedure‑specific impact of body mass index on robot‑derived intraoperative telemetry: a retrospective single‑surgeon cohort study.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2026Article
- The impact of a 24-hour call shift on cognitive function and simulated resuscitation performance in anaesthesia providers: a pilot study.BMC anesthesiology · 2026Observational
- The education of the orthopaedic surgeon's hand with the tool.International orthopaedics · 2026Article
- Dynamic patterns of communication and workload during cardiac surgery: An explorative study.PloS one · 2026Article
- Using EEG to Assess Cognitive Fatigue in Real Time: A Medical Simulation Study.Medical science educator · 2025Article
- The association between the duration of surgery and risks of mortality and unplanned reoperation is modulated by the surgical start time.Scientific reports · 2025Article
- Feasibility of single-port laparoscopic appendectomy for retrocecal appendicitis: A propensity score-matched study with multi-port laparoscopic appendectomy.World journal of gastrointestinal surgery · 2025Article
- The Flush Model: A Novel Framework to Manage Surgeons' Mental Fatigue and Cognitive Load.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2025Review
- Application and exploration of surgical assistive arms in thoracoscopic surgery: a single-center retrospective study.Scientific reports · 2025Article
- A Comparison of Tissue Handling Forces Between a Novel Suturing Device for Standardised Abdominal Wall Closure and Manual Needle-Driver Suturing.Journal of abdominal wall surgery : JAWS · 2025Article
- A well-rested scalpel: a proposal for standardized guidelines on surgeon fatigue.Frontiers in health services · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWhile fatigue is an inevitable aspect of performing surgical procedures, lack of consensus remains on its effect on surgical performance. The aim of this systematic review was to assess the effect of non-muscular fatigue on surgical outcome.
methodsMEDLINE and Embase were searched up to 17 January 2023. Studies on students, learning, duty-hour restrictions, muscle fatigue, non-surgical or subjective outcome, the weekend effect, or time of admission were excluded. Studies were categorized based on real-life or simulated surgery. The Cochrane risk-of-bias tool was used to assess RCTs and the Newcastle-Ottawa scale was used to assess cohort studies. Due to heterogeneity among studies, data pooling was not feasible and study findings were synthesized narratively.
resultsFrom the 7251 studies identified, 134 studies (including 1 684 073 cases) were selected for analysis (110 real-life studies and 24 simulator studies). Of the simulator studies, 46% (11 studies) reported a deterioration in surgical outcome when fatigue was present, using direct measures of fatigue. In contrast, only 35.5% (39 studies) of real-life studies showed a deterioration, observed in only 12.5% of all outcome measures, specifically involving aggregated surgical outcomes.
conclusionAlmost half of simulator studies, along with one-third of real-life studies, consistently report negative effects of fatigue, highlighting a significant concern. The discrepancy between simulator/real-life studies may be explained by heightened motivation and effort investment in real-life studies. Currently, published fatigue and outcome measures, especially in real-life studies, are insufficient to fully define the impact of fatigue on surgical outcomes due to the absence of direct fatigue measures and crude, post-hoc outcome measures.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.