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Arch Surg. 2007 Aug;142(8):708-12; discussion 712-4.

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

Author information

1
Department of Surgery, Division of Trauma and Critical Care, University of Southern California Keck School of Medicine Los Angeles, CA, USA. asalim@surgery.usc.edu

Abstract

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.

PMID:
17709724
DOI:
10.1001/archsurg.142.8.708
[Indexed for MEDLINE]

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