Study: Overlapping surgeries boost complication risks

Concurrent surgeries in which a surgeon runs two operations at once increase the risk of surgical complications for patients undergoing hip surgery, according to a study published in JAMA Internal Medicine.

Members of the healthcare community have argued over the safety of overlapping surgeries ever since The Boston Globe's Spotlight Team issued a controversial report about Boston-based Massachusetts General Hospital's use of the surgical practice in 2015. Since then, researchers have published numerous peer-reviewed studies, which showed little difference in complication rates between single and concurrent surgeries in U.S. hospitals.

"This seems to be the first study to show an adverse effect from the practice of overlapping surgery," Alan L. Zhang, MD, an orthopedic surgeon at UC San Francisco Medical Center, wrote in an op-ed accompanying the study.

For the study, researchers analyzed clinical data from several health administrative databases for more than 90,000 hip operations at about 75 hospitals in Ontario, Canada. Researchers also looked at patient outcomes one year after surgery.

Of the procedures analyzed, 2,520 overlapped by more than 30 minutes with another surgical procedure performed by the same attending surgeon. Most surgeries overlapped for 30 to 60 minutes, although some were performed concurrently for up to three hours. Researchers found the longer the surgeries overlapped, the more likely patients were to experience a serious surgical complication within one year.

The risk of a surgical complication increased from 1.4 percent to 2.3 percent for patients undergoing elective hip replacements when the surgery overlapped with another procedure. For patients who underwent a hip fracture surgery, the risk rose from 6.4 percent to 10.4 percent.

"If your surgeon is in multiple places, there's an increased risk of having a complication," lead study author Bheeshma Ravi, MD, PhD, a hip surgeon at Sunnybrook Health Sciences, told The Boston Globe. "I think that just makes sense."

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