Risk Factors and Causes of Mortality Among Anesthesiologists: Evidence from a Libyan multicenter observational case-control study

Anesthesiologists are exposed to elevated occupational risks due to prolonged work hours and multifactorial stressors. This study identifies the risk factors of sudden death among resident anesthesiologists in Libya. A multicenter observational case-control study was conducted over seven months (September–December 2022), involving 88 anesthesiologists from nine public hospitals. Participants were chosen using a case-control method, with one death for every 11 anesthesiologists in the same locality. Data collection included a structured electronic questionnaire, WHO-standardized physical measurements, blood sampling, and cardiovascular assessments. Statistical analysis was performed using Power BI, applying Odds ratio χ², t-test, ANOVA, and regression models (p < 0.05 and 0.001). Demographically, the cohort was balanced by sex (52.27% male, 47.73% female; χ² = 0.15, P > 0.001), with a mean age of 39 (SD = 8.7) years, and married (67.05%; χ² = 14.98, P < 0.001). BMI analysis revealed a high prevalence of overweight (36.36%) and obesity (35.23%). Employment duration and smoking history also demonstrated significant variability (χ² = 34.97 and 39.23, respectively; P < 0.001). Psychosocial stressors were prevalent, with economic hardship (31.82%), family conflict (12.5%), and perceived isolation (15.91%) showing statistically significant disparities (P < 0.001). Clinically, chest pain (28.41%), hypertension (17.05%), and a strong familial disease burden (96.59%) were prominent, while fatigue lacked statistical significance (P > 0.05). Biomedical findings showed sex-based differences: males had elevated triglycerides (165.0 ± 118.2 mg/dL; p = 0.042), while females had higher HDL (56.5 ± 9.5 mg/dL; p < 0.001) and D-dimer levels (0.3 ± 0.1 µg/mL; p < 0.001). ECG and echocardiography were largely normal, though 26 physicians (29.5%) exhibited unexplained cardiac anomalies. Among these, 73.1% had both SARS-COV-2 infection and vaccination, with the highest anomaly rate among recipients of mixed vaccine doses (34.6%). These findings underscore the need for targeted occupational health strategies, routine cardiovascular screening, and further investigation into post-COVID-19 cardiac effects among frontline medical personnel.