title: Influence of previous night call and sleep deprivation on screening colonoscopy quality.
abstract: OBJECTIVE
  There are few studies evaluating the influence of sleep deprivation on endoscopic outcomes. To evaluate the effect of a previous night call on the quality of screening colonoscopies performed the following day.
  
  
  METHODS
  Average-risk patients undergoing screening colonoscopies were included. Quality metrics were retrospectively compared between two groups of post-call colonoscopies and colonoscopies performed by the same individuals not on call the night before: those performed by gastroenterologists who were only on call the night prior and those performed by gastroenterologists who performed emergent on-call procedures the night prior.
  
  
  RESULTS
  Between 1 July 2010 and 31 March 2012, 447 colonoscopies were performed by gastroenterologists who were on call only the night prior, 126 colonoscopies were performed by gastroenterologists who had completed on-call emergent procedures the night prior, and 8,734 control colonoscopies were completed. There was a lower percent of patients who were screened with adenomas detected in procedures performed by endoscopists who had performed emergent on-call procedures the night prior compared with the controls (30 vs. 39%, respectively; P=0.043). The mean withdrawal time for these colonoscopies was significantly longer than that for the control procedures (15.5 vs. 14.0 min; P=0.025). For the colonoscopies performed by endoscopists who were on call only the night prior, there was no significant difference in the percent of patients screened with adenomas detected compared with controls (42 vs. 39%, respectively; P=0.136).
  
  
  CONCLUSIONS
  (1) Despite longer withdrawal times, being on call the night prior and performing an emergent procedure lead to a significant 24% decrease in the adenoma detection rates. (2) It is imperative for screening physicians to be aware of the influence of sleep deprivation on procedural outcomes and to consider altering their practice accordingly.
authors: Division of Gastroenterology & Hepatology, School of Medicine & Public Health, University of Wisconsin, Madison, Wisconsin, USA.
authors: Mark
authors: M
authors: Benson
authors: Division of Gastroenterology & Hepatology, School of Medicine & Public Health, University of Wisconsin, Madison, Wisconsin, USA.
authors: Ian
authors: I
authors: Grimes
authors: Division of Gastroenterology & Hepatology, School of Medicine & Public Health, University of Wisconsin, Madison, Wisconsin, USA.
authors: Deepak
authors: D
authors: Gopal
authors: Division of Gastroenterology & Hepatology, School of Medicine & Public Health, University of Wisconsin, Madison, Wisconsin, USA.
authors: Mark
authors: M
authors: Reichelderfer
authors: Division of Gastroenterology & Hepatology, School of Medicine & Public Health, University of Wisconsin, Madison, Wisconsin, USA.
authors: Anurag
authors: A
authors: Soni
authors: Division of Gastroenterology & Hepatology, School of Medicine & Public Health, University of Wisconsin, Madison, Wisconsin, USA.
authors: Holly
authors: H
authors: Benson
authors: Division of Gastroenterology & Hepatology, School of Medicine & Public Health, University of Wisconsin, Madison, Wisconsin, USA.
authors: Kerstin
authors: K
authors: Austin
authors: Division of Gastroenterology & Hepatology, School of Medicine & Public Health, University of Wisconsin, Madison, Wisconsin, USA.
authors: Patrick
authors: P
authors: Pfau
mesh_terms: D039602:After-Hours Care; D002983:Clinical Competence; D003108:Colonic Diseases / Q000175:diagnosis*; D003113:Colonoscopy / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000592:standards; D008875:Middle Aged; D009551:Night Care; D011787:Quality of Health Care; D012189:Retrospective Studies; D012892:Sleep Deprivation / Q000150:complications*; D013997:Time Factors; D014922:Wisconsin