BACKGROUND: To date, work-hour restrictions have not been imposed on attending surgeons in the United States. The purpose of this study was to investigate the impact of working an overnight trauma shift on outcomes of general surgery operations performed the next day by the post-call attending physician. STUDY DESIGN: Consecutive patients over a 3.5-year period undergoing elective general surgical procedures were reviewed. Procedures were limited to hernia repairs (inguinal and ventral), cholecystectomies, and intestinal operations. Any operations that were performed the day after the attending surgeon had taken an overnight trauma shift were considered post-call (PC) cases; all other cases were considered nonpost-call (NP). Outcomes from the PC operations were compared with those from the NP operations. RESULTS: There were 869 patients identified; 132 operations were performed PC and 737 were NP. The majority of operations included hernia repairs (46%), followed by cholecystectomies (35%), and intestinal procedures (19%). Overall, the PC operations did not differ from the NP operations with respect to complication rate (13.7% vs 13.5%, p = 0.93) or readmission within 30 days (5% vs 6%, p = 0.84). Additionally, multivariable logistic regression failed to identify an association between PC operations and the development of adverse outcomes. Follow-up was obtained for an average of 3 months. CONCLUSIONS: Performance of general surgery operations the day after an overnight in-hospital trauma shift did not affect complication rates or readmission rates. At this time, there is no compelling evidence to mandate work-hour restrictions for attending general surgeons.
BACKGROUND: To date, work-hour restrictions have not been imposed on attending surgeons in the United States. The purpose of this study was to investigate the impact of working an overnight trauma shift on outcomes of general surgery operations performed the next day by the post-call attending physician. STUDY DESIGN: Consecutive patients over a 3.5-year period undergoing elective general surgical procedures were reviewed. Procedures were limited to hernia repairs (inguinal and ventral), cholecystectomies, and intestinal operations. Any operations that were performed the day after the attending surgeon had taken an overnight trauma shift were considered post-call (PC) cases; all other cases were considered nonpost-call (NP). Outcomes from the PC operations were compared with those from the NP operations. RESULTS: There were 869 patients identified; 132 operations were performed PC and 737 were NP. The majority of operations included hernia repairs (46%), followed by cholecystectomies (35%), and intestinal procedures (19%). Overall, the PC operations did not differ from the NP operations with respect to complication rate (13.7% vs 13.5%, p = 0.93) or readmission within 30 days (5% vs 6%, p = 0.84). Additionally, multivariable logistic regression failed to identify an association between PC operations and the development of adverse outcomes. Follow-up was obtained for an average of 3 months. CONCLUSIONS: Performance of general surgery operations the day after an overnight in-hospital trauma shift did not affect complication rates or readmission rates. At this time, there is no compelling evidence to mandate work-hour restrictions for attending general surgeons.
Authors: Peter I Ellman; Marianna G Law; Carlos Tache-Leon; T Brett Reece; Thomas S Maxey; Benjamin B Peeler; John A Kern; Curtis G Tribble; Irving L Kron Journal: Ann Thorac Surg Date: 2004-09 Impact factor: 4.330
Authors: Laura K Barger; Brian E Cade; Najib T Ayas; John W Cronin; Bernard Rosner; Frank E Speizer; Charles A Czeisler Journal: N Engl J Med Date: 2005-01-13 Impact factor: 91.245
Authors: Christopher P Landrigan; Jeffrey M Rothschild; John W Cronin; Rainu Kaushal; Elisabeth Burdick; Joel T Katz; Craig M Lilly; Peter H Stone; Steven W Lockley; David W Bates; Charles A Czeisler Journal: N Engl J Med Date: 2004-10-28 Impact factor: 91.245
Authors: Jaisa Olasky; Amine Chellali; Ganesh Sankaranarayanan; Likun Zhang; Amie Miller; Suvranu De; Daniel B Jones; Steven D Schwaitzberg; Benjamin E Schneider; Caroline G L Cao Journal: Surg Endosc Date: 2014-03-27 Impact factor: 4.584