London Daily

Focus on the big picture.
Wednesday, Oct 22, 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

0:00
0:00
Close
‘Frightening’ First Night in Prison for Sarkozy: Inmates Riot and Shout ‘Little Nicolas’
White House Announces No Imminent Summit Between Trump and Putin
US and Qatar Warn EU of Trade and Energy Risks from Tough Climate Regulation
Apple Challenges EU Digital Markets Act Crackdown in Landmark Court Battle
Nicolas Sarkozy begins five-year prison term at La Santé in Paris
Japan stocks surge to record as Sanae Takaichi becomes Prime Minister
This Is How the 'Heist of the Century' Was Carried Out at the Louvre in Seven Minutes: France Humiliated as Crown with 2,000 Diamonds Vanishes
China Warns UK of ‘Consequences’ After Delay to London Embassy Approval
France’s Wealthy Shift Billions to Luxembourg and Switzerland Amid Tax and Political Turmoil
"Sniper Position": Observation Post Targeting 'Air Force One' Found Before Trump’s Arrival in Florida
Shouting Match at the White House: 'Trump Cursed, Threw Maps, and Told Zelensky – "Putin Will Destroy You"'
Windows’ Own ‘Siri’ Has Arrived: You Can Now Talk to Your Computer
Thailand and Singapore Investigate Cambodian-Based Prince Group as U.S. and U.K. Sanctions Unfold
‘No Kings’ Protests Inflate Numbers — But History Shows Nations Collapse Without Strong Executive Power
Chinese Tech Giants Halt Stablecoin Launches After Beijing’s Regulatory Intervention
Manhattan Jury Holds BNP Paribas Liable for Enabling Sudanese Government Abuses
Trump Orders Immediate Release of Former Congressman George Santos After Commuting Prison Sentence
S&P Downgrades France’s Credit Rating, Citing Soaring Debt and Political Instability
Ofcom Rules BBC’s Gaza Documentary ‘Materially Misleading’ Over Narrator’s Hamas Ties
Diane Keaton’s Cause of Death Revealed as Pneumonia, Family Confirms
Former Lostprophets Frontman Ian Watkins Stabbed to Death in British Prison
"The Tsunami Is Coming, and It’s Massive": The World’s Richest Man Unveils a New AI Vision
Outsider, Heroine, Trailblazer: Diane Keaton Was Always a Little Strange — and Forever One of a Kind
Dramatic Development in the Death of 'Mango' Founder: Billionaire's Son Suspected of Murder
Two Years of Darkness: The Harrowing Testimonies of Israeli Hostages Emerging From Gaza Captivity
EU Moves to Use Frozen Russian Assets to Buy U.S. Weapons for Ukraine
Europe Emerges as the Biggest Casualty in U.S.-China Rare Earth Rivalry
HSBC Confronts Strategic Crossroads as NAB Seeks Only Retail Arm in Australia Exit
U.S. Chamber Sues Trump Over $100,000 H-1B Visa Fee
Shenzhen Expo Spotlights China’s Quantum Step in Semiconductor Self-Reliance
China Accelerates to the Forefront in Global Nuclear Fusion Race
Yachts, Private Jets, and a Picasso Painting: Exposed as 'One of the Largest Frauds in History'
Australia’s Wedgetail Spies Aid NATO Response as Russian MiGs Breach Estonian Airspace
McGowan Urges Chalmers to Cut Spending Over Tax Hike to Close $20 Billion Budget Gap
Victoria Orders Review of Transgender Prison Placement Amid Safety Concerns for Female Inmates
U.S. Treasury Mobilises New $20 Billion Debt Facility to Stabilise Argentina
French Business Leaders Decry Budget as Macron’s Pro-Enterprise Promise Undermined
Trump Claims Modi Pledged India Would End Russian Oil Imports Amid U.S. Tariff Pressure
Surging AI Startup Valuations Fuel Bubble Concerns Among Top Investors
Australian Punter Archie Wilson Tears Up During Nebraska Press Conference, Sparking Conversation on Male Vulnerability
Australia Confirms U.S. Access to Upgraded Submarine Shipyard Under AUKUS Deal
“Firepower” Promised for Ukraine as NATO Ministers Meet — But U.S. Tomahawks Remain Undecided
Brands Confront New Dilemma as Extremists Adopt Fashion Labels
The Sydney Sweeney and Jeans Storm: “The Outcome Surpassed Our Wildest Dreams”
Erika Kirk Delivers Moving Tribute at White House as Trump Awards Charlie Presidential Medal of Freedom
British Food Influencer ‘Big John’ Detained in Australia After Visa Dispute
ScamBodia: The Chinese Fraud Empire Shielded by Cambodia’s Ruling Elite
French PM Suspends Macron’s Pension Reform Until After 2027 in Bid to Stabilize Government
Orange, Bouygues and Free Make €17 Billion Bid for Drahi’s Altice France Telecom Assets
Dutch Government Seizes Chipmaker After U.S. Presses for Removal of Chinese CEO
×