Increased sympathovagal balance during first five minutes of surgery not associated with reduced ICU stay or mortality
By Elana Gotkine HealthDay Reporter
WEDNESDAY, Jan. 15, 2025 (HealthDay News) — Increased surgeon stress at the beginning of a surgical procedure is associated with reduced major surgical complications, according to a study published online Jan. 15 in JAMA Surgery.
Jake Awtry, M.D., from Brigham and Women’s Hospital in Boston, and colleagues conducted a multicenter prospective cohort study in 14 surgical departments within four university hospitals to examine whether surgeon physiological stress, as assessed by sympathovagal balance, is associated with postoperative complications. The analysis included 793 surgical procedures performed by 38 attending surgeons.
The median surgeon heart rate was 88 beats per minute, and the median low-frequency to high-frequency ratio was 7.16 and 1.00 before and after normalization, respectively. The researchers observed an association for increased surgeon sympathovagal balance during the first five minutes of surgery with significantly reduced major surgical complications (adjusted odds ratio, 0.63; 95 percent confidence interval, 0.41 to 0.98; P = 0.04); associations were not seen with reduced intensive care unit stay (adjusted odds ratio, 0.34; 95 percent confidence interval, 0.11 to 1.01; P = 0.05) or mortality (adjusted odds ratio, 0.18; 95 percent confidence interval, 0.03 to 1.03; P = 0.05).
“The results suggest an association between human factors elements and patient outcomes while highlighting the complex association between physiological stress and surgeon performance,” the authors write.
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