A new study has revealed that patients, who undergo a neurosurgical procedure with surgical start times between 9 pm and 7 am, are at an increased risk of developing complications compared to patients with a surgical start time earlier in the day. Numerous surgeries – regardless of type or form – take place on a daily basis across the globe.

While some are emergencies, others are necessary. However, as we go about our daily lives, do we wonder about the time of day a surgery takes place at? The answer is no. But, in the case of neurosurgical procedures, the time of day does matter. Neurosurgical procedures are a type of medical specialty which is concerned with the prevention, diagnosis, surgical treatment, and rehabilitation of disorders which affect any portion of the nervous system including the brain, spinal cord, peripheral nerves, and extra-cranial cerebrovascular system. India has witnessed a growth in numbers of neuro-related problems in recent years. There are total of 3,800 neurosurgeons in India, which is still very less if compared to the population of the country. In the past 30 years, the number of neurosurgery centres has increased from the original three centres at Vellore, Madras and Mumbai to many units distributed in different parts of the country. These neurosurgical procedures are necessary at all times of the day and are performed at any time when required. The scientists analysed all patients undergoing neurological surgery between 2007 and 2014 in the University of Michigan Health System. The research included 15,807 patients. 785 complications were identified through the self-reported morbidity and mortality reports created by faculty and resident neurosurgeons. The study showed that the odds of a complication were increased by more than 50% for procedures with start times between 9 pm and 7 am. When accounting for the length of the surgery, the odds of a complication were even greater for later time periods. The only statistically significant factor that predicted severity of the complication was if the operation was an emergency compared to an elective surgery. According to the researchers, it is really important to understand whether surgical start time might be related to neurosurgical procedural complications. The analysis demonstrated that a patient’s odds of having a surgical complication increased significantly between 9 pm and 7 am even after accounting for whether the case was an emergency versus elective procedure or if the patient had co-morbid conditions. When accounting for the length of the surgery, the odds of a complication more than doubled. The study’s lead author Aditya Pandey said, “We need to continue to study this relationship as we aim to minimise surgery-related complications.” The study was published in journal Neurosurgery.

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