Impact of the 80-hour workweek on patient care at a level I trauma center.
OBJECTIVE
The 80-hour workweek limitation for surgical residents is associated with an increase in mortality and complication rates among adult trauma surgical patients.


METHODS
Retrospective cohort study.


METHODS
Academic level I trauma center.


METHODS
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.


METHODS
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).


CONCLUSIONS
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.
Salim
Ali
A
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
Teixeira
Pedro G R
PG
Chan
Linda
L
Oncel
Didem
D
Inaba
Kenji
K
Brown
Carlos
C
Rhee
Peter
P
Berne
Thomas V
TV
D000328:Adult; D002055:Burnout, Professional / Q000453:epidemiology*; D002140:California / Q000453:epidemiology; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D008297:Male; D010561:Personnel Staffing and Scheduling; D011787:Quality of Health Care; D012189:Retrospective Studies; D012307:Risk Factors; D014193:Trauma Centers / Q000706:statistics & numerical data*; D014940:Work Schedule Tolerance; D016526:Workload / Q000706:statistics & numerical data*