Saudi Press

Saudi Arabia and the world
Monday, Jun 23, 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

Saudi Press
0:00
0:00
Close
WATCH: Israeli forces show the aftermath of a massive airstrike at Iran's Isfahan nuclear site
We have new information and breaking details to share about what is shaping up to be a historic air campaign tonight
Six Massive Bombs Dropped on Fordow; Trump: 'A Historic Moment for the U.S., Israel, and the World'
Fordow: Deeply Buried Iranian Enrichment Site in U.S.–Israel Crosshairs
United States Conducts Precision Strikes on Iran’s Nuclear Sites
US strikes Iran nuclear sites, Trump says
Pakistan to nominate Trump for Nobel Peace Prize.
Israel Confirms Assassination of Quds Force Commander in Tehran
16 Billion Login Credentials Leaked in Unprecedented Cybersecurity Breach
Senate hearing on who was 'really running' Biden White House kicks off
G7 Leaders Fail to Reach Consensus on Key Global Issues
Mass exodus in Tehran as millions try to flee following Trump’s evacuation order
Iranian Military Officers Reportedly Seek Contact with Reza Pahlavi, Signal Intent to Defect
Vietnam Emerges as Luxury Yacht Destination for Ultra‑Rich
China's Iranian Oil Imports Face Disruption Amid Escalating Middle East Tensions
Trump Demands Iran's Unconditional Surrender Amid Escalating Conflict
Israeli Airstrike Targets Iranian State TV in Central Tehran
President Trump is leaving the G7 summit early and has ordered the National Security Council to the Situation Room
Netanyahu Signals Potential Regime Change in Iran
Analysts Warn Iran May Resort to Unconventional Warfare
Iranian Regime Faces Existential Threat Amid Conflict
Energy Infrastructure Becomes War Zone in Middle East
Iran Conducts Ballistic Missile Launches Amid Heightened Tensions with Israel
Iran Signals Openness to Nuclear Negotiations Amid Ongoing Regional Tensions
Shock Within Iran’s Leadership: Khamenei’s Failed Plan to Launch 1,000 Missiles Against Israel
Trump's Anti-War Stance Tested Amid Israel-Iran Conflict
UK Deploys Jets to Middle East Amid Rising Tensions
Exiled Iranian Prince Reza Pahlavi Urges Overthrow of Khamenei Regime
Wreck of $17 Billion San José Galleon Identified Off Colombia After 300 Years
Iran Launches Extensive Missile Attack on Israel Following Israeli Strikes on Nuclear Sites
Israel Issues Ultimatum to Iran Over Potential Retaliation and Nuclear Facilities
Black Box Recovered from Air India Crash Site
Coinbase CEO Warns Bitcoin Could Supplant US Dollar Amid Mounting National Debt
Trump to Iran: Make a Deal — Sign or Die
Operation "Like a Lion": Israel Strikes Iran in Unprecedented Offensive
Israel Launches 'Operation Rising Lion' Targeting Iranian Nuclear and Military Sites
Israeli Forces Intercept Gaza-Bound Aid Vessel Carrying Greta Thunberg
IMF Warns of Severe Global Trade War Impacts on Emerging Markets
Syria to Reconnect to Global Economy After 14 Years of Isolation
Israel Confirms Arming Gaza Clan to Counter Hamas Influence
Global News Roundup: From Ukraine's strategic military strikes and Russia's demands and Tensions Escalate in Ukraine, to serious legal issues faced by Britons in Bali and Trump's media criticism, the latest developments highlight a turbulent landscape
U.S. Reduces Military Presence in Syria
Trump Demands Iran End All Uranium Enrichment in Nuclear Talks
Iran Warns Europe Against Politicizing UN Nuclear Report
Paris Saint-Germain's Greatest Triumph Is Football’s Lowest Point
OPEC+ Agrees to Increase Oil Output for Third Consecutive Month
Turkey Detains Istanbul Officials Amid Anti-Corruption Crackdown
Meta and Anduril Collaborate on AI-Driven Military Augmented Reality Systems
EU Central Bank Pushes to Replace US Dollar with Euro as World’s Main Currency
European and Arab Ministers Convene in Madrid to Address Gaza Conflict
×