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A study published in a recent issue of the Journal of the American Medical Association suggests that attending surgeons and obstetricians who sleep fewer than six hours between shifts may be at increased risk for making surgical errors, the Boston Globe reports. To evaluate which factors contribute to errors, researchers from Brigham and Women's Hospital and colleagues analyzed 919 surgical and 957 obstetrical procedures performed between January 1999 and June 2008 at the facility by 86 surgeons and 134 obstetricians and gynecologists who had performed procedures the preceding night. They matched the procedures to a control group of 3,552 surgical and 3,945 obstetrical procedures performed by the same physician on days when physicians did not perform procedures the previous night. Complication rates among procedures performed by attending surgeons and obstetricians who worked the preceding night showed a slight, statistically insignificant increase of 5.4 percent compared with 4.9 percent among control procedures. However, the rate of complications—including site infections, massive hemorrhage, organ injury and wound failures—increased to 6.2 percent among physicians who had sleep opportunities of six hours or less the previous night, compared with 3.4 percent among physicians who had sleep opportunities of more than six hours. The researchers calculated "sleep opportunity" as the time between the end of a physician's last overnight procedure and the beginning of their first procedure on the following day. Noting that the idea of the "limitless work week for attending physicians is not optimal for patient care," the researchers state that surgeons and obstetricians, in addition to residents and nurses, may be at increased risk of errors and procedural complications when they are sleep-deprived or working extended shifts. Although the findings cannot be generalized beyond similar teaching hospitals, the researchers recommend that hospital administrators consider making backup personnel available to help surgeons that may need to cancel or postpone elective procedures because of insufficient rest (Cooney, Boston Globe, 10/13/09 [registration required]; DerGurahian, Modern Healthcare, 10/13/09 [subscription required]; Rothschild et al., Journal of the American Medical Association, 10/14/09 [subscription required]).