We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Comment & Response |

Next-Day Surgical Complications After Nighttime Procedures—Reply

Christopher Vinden, MD1; Danielle Nash, MSc2
[+] Author Affiliations
1Division of General Surgery, Western University, London, Ontario, Canada
2Institute for Clinical Evaluative Sciences, London, Ontario, Canada
JAMA. 2014;311(8):861-862. doi:10.1001/jama.2014.333.
Text Size: A A A
Published online


In Reply We agree with Dr Hou and colleagues that it would be informative to determine the degree of sleep deprivation among physicians in our study; however, our databases do not allow us to identify the actual duration of sleep opportunity.

The subgroup analysis by Rothschild et al1 (Table 6) is interesting in that those surgeons who operated at night but had more than 6 hours of sleep opportunity had a lower complication rate (3.1%) than the surgeons in the control group from the primary analysis who did not operate at all the night before (7.1%). Whether this result reached statistical significance when adjusted for age, sex, and comorbidities was not published; however, a simple 2-by-2 contingency table analysis suggests that it did. Thus, it may not be accurate to conclude that this study showed that sleep opportunity has a significant association with complication rates.


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview




February 26, 2014
Lijun Hou, MD, PhD; Xi Han, MD, PhD; Yan Dong, MD, PhD
1Department of Neurosurgery, Changzheng Hospital, Shanghai, China
2Department of Neurosurgery, Huashan Hospital, Shanghai, China
JAMA. 2014;311(8):860-861. doi:10.1001/jama.2014.330.
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...