Surgeons in the United States had significantly higher mortality rates than non-surgeon physicians in 2023, based on newly analyzed national death records.
The findings suggest that surgical practice may be associated with unique health risks.
The study examined 1,080,298 adult deaths among individuals aged 25 to 74 years. This included 224 deaths among surgeons and 2,740 among non-surgeon physicians. Mortality rates were age- and sex-adjusted to the 2000 U.S. standard population.
Surgeons had a mortality rate of 355.3 deaths per 100,000 population (95% CI, 274.5-458.8), compared with 228.4 deaths per 100,000 among non-surgeon physicians (95% CI, 218.7-238.4). This yielded a mortality rate ratio (MRR) of 1.56 (95% CI, 1.36-1.78).
“Although non-surgeon physicians have lower mortality rates than other highly educated professionals,” wrote lead author Vishal R. Patel, MD, MPH, of Harvard Medical School and Brigham and Women’s Hospital. “This mortality benefit does not extend to surgeons.”
The mortality rate among surgeons was similar to that of lawyers, engineers, and scientists, who had a rate of 404.5 per 100,000 (95% CI, 397.5-411.6; MRR, 0.88 [95% CI, 0.77-1.00]). Surgeons had lower mortality than the general workforce, whose rate was 632.5 per 100,000 (95% CI, 631.3-633.7; MRR, 0.56 [95% CI, 0.49-0.64]).
Neoplasms were the leading cause of death among surgeons, with a rate of 193.2 per 100,000 (95% CI, 128.2-284.0), more than double the rate among non-surgeon physicians (87.5 [95% CI, 81.4-94.0]; MRR, 2.21 [95% CI, 1.75-2.80]). Heart disease was the second leading cause in both groups.
Motor vehicle collisions were the fourth most common cause of death among surgeons but ranked ninth in other occupational groups. Other leading causes of death in surgeons included unintentional injuries (third), suicide (fifth), stroke (sixth), liver disease (seventh), hypertension (eighth), and assault (ninth).
The data came from the 2023 National Vital Statistics System, which includes all registered U.S. deaths. Population denominators were obtained from the 2023 American Community Survey and counts for surgeons and physicians were cross-verified using the AMA Physician Masterfile. Usual occupation was defined as the primary lifetime occupation, as reported by informants.
The study authors noted that despite comparable medical knowledge and access to care, surgeons had higher mortality rates than non-surgeon physicians. They suggested this may be related to occupational factors such as extended work hours, exposure to hazards, and job-related stress. However, the analysis could not assess long-term trends due to the availability of only 1 year of mortality data.
The researchers stated, although the number of deceased surgeons was small, it accurately reflects the size of the national surgical workforce, and all qualifying surgeon deaths were included.
Further research is needed to explore the occupational drivers behind the elevated mortality seen in surgeons, particularly in cancer-related and injury-related deaths.
Full disclosures can be found in the published study.
Source: JAMA Surgery
