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Ann Thorac Surg 2005;80:2420-2421
© 2005 The Society of Thoracic Surgeons

Correspondence

Reply

Irving L. Kron, MD, Peter I. Ellman, MD

Department of Surgery, UVA Health System, PO Box 800679, Charlottesville, VA 22908

(Email: ilk{at}virginia.edu).

To the Editor:

We appreciate very much Dr Totaro's interest [1] in our study [2]. We recognized that such a study would be controversial and would result in significant discussion. As Dr Totaro noted, we clearly stated the limitations of this study and our rationale for performing it. We do not argue at all the work hour regulations that have been applied to residents, and we certainly support them completely in our program. We have a little more difficulty with artificial restrictions on attending surgeons because there is little if any data to impose them. In our study we found no evidence of inferior cardiac surgery results performed by attending surgeons who had sleep deprivation. Therefore we disagree that the results of our study are dangerous. We recognize that it may be the system that we work in that makes the results of both groups equivalent. That is precisely the point. Sleep deprivation as we defined it was not an independent predictor of inferior results. Therefore we cannot support artificial work hour restrictions for attending surgeons.


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  1. Totaro P. Sleep deprivation and results in cardiac surgerydangerous study with very dangerous conclusions (letter). Ann Thorac Surg 2005;80:2420.[Free Full Text]
  2. Ellman PI, Law MG, Tache-Leon C, et al. Sleep deprivation does not affect operative results in cardiac surgery Ann Thorac Surg 2004;78:906-911.[Abstract/Free Full Text]

Related Article

Sleep Deprivation and Results in Cardiac Surgery: Dangerous Study With Very Dangerous Conclusions
Pasquale Totaro
Ann. Thorac. Surg. 2005 80: 2420. [Extract] [Full Text] [PDF]




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