Photo Credit: Maridav

Heightened surgeon stress at the beginning of a procedure was associated with better patient outcomes, highlighting the complex relationship between physiological stress and performance, according to results published in JAMA Surgery. Jake Awtry MD, MA, and colleagues assessed whether surgeon physiological stress, measured by sympathovagal balance, was associated with postoperative complications across 793 procedures. The median surgeon heart rate was 88 (interquartile range [IQR], 77-99) beats per minute. Median surgeon low frequency to high-frequency ratio was 7.16 (IQR, 4.52-10.72) before and 1.00 (IQR, 0.71-1.32) after normalization. Greater surgeon sympathovagal balance in the first 5 minutes of a procedure was associated with fewer major surgical complications (adjusted OR [aOR], 0.63; 95% CI, 0.41-0.98), but not with a decrease in ICU stay (aOR, 0.34; 95% CI, 0.11-1.01) or mortality (aOR, 0.18; 95% CI, 0.03-1.03). The findings “identify a novel association between measurable surgeon human factors and patient outcomes and may highlight opportunities to improve patient care,” Dr. Awtry and colleagues wrote.