Findings from a new analysis suggest overlapping surgery is likely to be a safe practice for most patients, but certain groups may be at higher risk of increased mortality and complications.
The retrospective study examined associations between overlapping surgery and in-hospital mortality, in-hospital post-operative complications and length of surgery among 66,430 procedures performed by 207 surgeons. The procedures included total knee or hip arthroplasty; lumbar, thoracic, or cervical spine surgery; coronary artery bypass graft (CABG) surgery or craniotomy.
Seventy-three per cent of surgeons performed overlapping procedures and among these, the mean percentage of a surgeon’s cases that were overlapping was 12 per cent.
The study found no significant difference between overlapping versus non-overlapping surgery for in-hospital mortality (1.9% versus 1.6%, respectively) or post-operative complications (12.8% versus 11.8%, respectively). Overlapping surgery was, however, significantly associated with increased surgery length (204 versus 173 minutes).
An exploratory subgroup analysis found that in high-risk versus low-risk patients, overlapping surgery was significantly associated with increased mortality (5.8% versus 4.7%; P=.03) and complications rate (29.2% versus 27.0%; P=.03).
Writing in JAMA, the authors said the findings among high-risk patients warrant further investigation.