Surgery causes transient impairment in cognition and function, which may impact driving safety. We hypothesized that the risk of a motor vehicle crash would increase after compared to before surgery.


We performed a nested case-crossover study within population-based observational data from the New Jersey Safety Health Outcomes Data Warehouse. We included adults aged ≥ 18 years with a valid driver’s license who underwent general surgery in an acute care hospital in New Jersey between January 1st, 2016 and November 30th, 2017 and were discharged home. Individuals served as their own controls within a pre-surgery interval (56 days to 28 days before surgery) and post-surgery interval (discharge through 28 days after surgery). General surgery was defined by Common Procedural Terminology Codes. Our primary outcome was a police-reported motor vehicle crash.


In a cohort of 70,722 drivers, the number of crashes after surgery was 263 (0.37%) compared to 279 (0.39%) before surgery. Surgery was not associated with a change in crash incidence over 28 days using a case-crossover design (adjusted incidence rate ratio of 0.92, 95% CI 0.78, 1.09; p = 0.340). Statistical interaction was present for sex and hospital length of stay. Younger versus older adults (adjusted risk ratio 1.87, 95% CI: 1.10, 3.18, p = 0.021) and non-Hispanic Black individuals (adjusted risk ratio 1.96, 95% CI 1.33, 2.88; p = 0.001) and Hispanic individuals (adjusted risk ratio 1.38, 95% CI: 1.00, 1.91, p = 0.047) versus non-Hispanic White individuals had a greater risk of a crash after surgery.


Using population-based crash and hospital discharge data, the incidence of motor vehicle crashes over a 28 day period did not change on average before compared to after surgery. We provide data on crash risk after surgery and highlight specific populations at risk.

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