Patients who had angioplasty performed by a sleep-deprived physician fared about the same as those whose procedure was done by a rested physician, according to a study in JACC: Cardiovascular Interventions. Researchers found no significant differences in patient mortality between angioplasty completed by the two groups of physicians.
Using data from the National Cardiovascular Data Registry’s (NCDR) CathPCI Registry, researchers assessed more than 1.5 million procedures performed between 7 a.m. and midnight by more than 5,000 physicians during a three-year period from 2009 through 2012. Physicians were considered acutely sleep-deprived if they began a middle-of-the-night angioplasty between midnight and 6:59 a.m. and performed a next-day procedure between 7 a.m. and midnight. Researchers defined physicians as chronically sleep-deprived if they had performed multiple middle-of-the-night procedures during the previous seven days.
Only a small number of daytime procedures—2.4%—were performed by physicians who had conducted at least one angioplasty in the middle of the night. That comes down to about one in 40 procedures. Angioplasty performed under those conditions was not elective, suggesting that physicians opted to defer if at all possible.
The only difference found in performance was among physicians with chronic sleep deprivation. Researchers found a significantly greater adjusted risk of bleeding—about a 20% increase—in the small number of procedures performed by this group.