JOURNAL ARTICLE
MULTICENTER STUDY

Impact of the 80-hour workweek on patient care at a level I trauma center

Ali Salim, Pedro G R Teixeira, Linda Chan, Didem Oncel, Kenji Inaba, Carlos Brown, Peter Rhee, Thomas V Berne
Archives of Surgery 2007, 142 (8): 708-12; discussion 712-4
17709724

HYPOTHESIS: The 80-hour workweek limitation for surgical residents is associated with an increase in mortality and complication rates among adult trauma surgical patients.

DESIGN: Retrospective cohort study.

SETTING: Academic level I trauma center.

PATIENTS: Trauma patients admitted before and after the 80-hour workweek limitation.

METHODS: We compared death and complication rates for adult trauma patients admitted during a 24-month period before (2001-2003) and a 24-month period after (2004-2006) implementation of the 80-hour workweek at our institution. Relative risk and its 95% confidence intervals were examined.

MAIN OUTCOME MEASURES: Patient care outcomes included preventable and nonpreventable complications and deaths.

RESULTS: The patient populations from the 2 time periods were clinically similar. No significant differences were found in the total and the preventable death rates. The time period after the 80-hour workweek mandate had a significantly higher total complication rate (5.64% vs 7.28%; relative risk, 1.29; 95% confidence interval, 1.15-1.45; P < .001), preventable complication rate (0.89% vs 1.28%; relative risk, 1.43; 95% confidence interval, 1.06-1.91; P = .02), and nonpreventable complication rate (4.75% vs 5.81%; relative risk, 1.22; 95% confidence interval, 1.08-1.39; P = .002).

CONCLUSION: Although there was no difference in deaths between the 2 time periods, there was a significant increase in total, preventable, and nonpreventable complications. This increase in complication rate may be due, in part, to the new 80-hour workweek policy.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
17709724
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"