Burnout among neurosurgical professionals: a systematic review and meta-analysis of prevalence and determinants
摘要
Burnout is a major concern in neurosurgery, residents and attending neurosurgeons and linked to impaired performance and patient safety.
ObjectiveTo estimate the prevalence of burnout among neurosurgical professionals, summarize Maslach Burnout Inventory (MBI) subscale scores, and explore geographic, temporal, and determinant patterns.
MethodsWe performed a PRISMA 2020–compliant systematic review and meta-analysis of observational studies reporting burnout in neurosurgical residents and/or attendings using validated instruments, searched through April 2025. The primary analysis pooled studies using a standardized MBI-based definition (emotional exhaustion ≥ 27 or depersonalization ≥ 10). Random-effects models (restricted maximum likelihood, Hartung–Knapp adjustment) were applied to logit-transformed prevalences, reporting pooled prevalence with 95% confidence intervals (CI), 95% prediction intervals (PI), and I². Risk of bias was assessed with Joanna Briggs Institute checklists.
ResultsTwenty-nine studies including 8,063 neurosurgical professionals were identified, of whom 6,077 contributed to the primary MBI-based meta-analysis. The pooled prevalence of burnout was 45% (95% CI 36–55%), with extreme heterogeneity (I² = 97.4%; τ² = 0.53) and a wide 95% PI (14–80%), indicating marked variability across settings. Point estimates were higher among residents than attending neurosurgeons, but uncertainty was substantial and subgroup differences were not supported under random-effects models. Differences across pre-, during, and post–COVID-19 periods were inconclusive. Excessive workload, long working hours, sleep deprivation, poor work–life balance, and limited institutional support were the most frequent risk factors, while protective factors were less consistently reported.
ConclusionBurnout is common among neurosurgical professionals worldwide, but prevalence estimates vary widely, and extreme between-study heterogeneity indicates that the dominant signal in the literature is methodological inconsistency rather than a single universal prevalence. More standardized measurement and context-sensitive, system-level interventions are urgently needed to mitigate burnout and safeguard neurosurgeon well-being, patient safety, and the long-term sustainability of the neurosurgical workforce.