A Contemporary Survey of The Impact of Perioperative Catastrophes on Anesthesiologists
Rebecca Margolis, Lauren Licatino, H. Daniel Adams, K. Elliott Higgins, Norah R. Janosy, Saral Patel, Allison Dalton, Bashira A. Oloso, Steven J. Staffa, Anoushka Afonso, Amy E. VinsonBackground:
Perioperative catastrophes are sentinel events in anesthesiology with well-described emotional and professional consequences. A landmark national survey published in 2012 demonstrated substantial and prolonged distress among anesthesiologists following such events. Since 2012, anesthesiology practice has evolved within a healthcare environment characterized by persistent workforce strain, heightened attention to clinician well-being, and expansion of peer-support programs. A contemporary reassessment is warranted.
Methods:
A voluntary, anonymous electronic survey was distributed in 2025 to U.S.-based members of the American Society of Anesthesiologists who had opted to receive research surveys. The 44-item instrument was adapted from the 2012 questionnaire to preserve longitudinal comparability while incorporating contemporary support modalities. Domains included experience with perioperative catastrophes, characteristics of a memorable event, emotional and physical sequelae, impact on clinical performance, recovery trajectories, and perceptions of institutional support. Descriptive analyses were performed.
Results:
Of 1,725 respondents included in analysis (response rate 7.1%), 94.2% reported involvement in at least one perioperative catastrophe during their careers. Following a memorable event, 72.5% reported physical symptoms and 91.6% reported psychosocial symptoms. Most respondents perceived impairment in ability to provide anesthesia care in the first 4 hours (69.0%) and 24 hours (61.5%) after the event. Nearly one-fifth (19.7%) reported never fully recovering emotionally, closely mirroring rates reported in 2012. Although informal peer support was common, formal debriefing and institutionally supported time off were infrequently provided. Nearly one-quarter of respondents reported considering leaving anesthesiology as a result of a perioperative catastrophe.
Conclusion:
Perioperative catastrophes remain a common experience in anesthesiology and continue to carry substantial and enduring consequences. Despite increased cultural awareness, there remains a gap between recognition of their impact and clinicians’ reported recovery experiences. Routine integration of peer support, nonpunitive debriefing, and flexible duty relief may represent critical opportunities to improve clinician well-being, patient safety, and workforce sustainability.