title: Outcomes of operations performed by attending surgeons after overnight trauma shifts.
abstract: 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.
  
  
  METHODS
  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: Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA.
authors: John P
authors: JP
authors: Sharpe
authors: Jordan A
authors: JA
authors: Weinberg
authors: Louis J
authors: LJ
authors: Magnotti
authors: Simonne S
authors: SS
authors: Nouer
authors: Wonsuk
authors: W
authors: Yoo
authors: Ben L
authors: BL
authors: Zarzaur
authors: Darren R
authors: DR
authors: Cullinan
authors: Leah E
authors: LE
authors: Hendrick
authors: Timothy C
authors: TC
authors: Fabian
authors: Martin A
authors: MA
authors: Croce
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008505:Medical Staff, Hospital; D010561:Personnel Staffing and Scheduling; D013514:Surgical Procedures, Operative; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000601:surgery