Work Hour Reduction: Still Room for Improvement
Abstract
The effect of resident duty hour restrictions continues to yield conflicting results on patient outcomes. Failure to rescue (FTR), or death after a major complication, has become a topic of increasing quality assessment. The aim of this study is to evaluate the effect of duty hour restrictions on in-hospital mortality, complication rates, and FTR in patients suffering traumatic injuries. Data from the National Trauma Data Bank (NTDB) were retrospectively reviewed (Research Data Set 2007-2008 and version 7.2). Patients admitted to Level I or II teaching institutions were dichotomized into pre-duty hour restriction (2002-2003) and post-duty hour restriction (2007-2008) time periods. Patients who had nonsurvivable injuries (any region Abbreviated Injury Scale score = 6), died within 48 hours, or had missing data were excluded. Multivariate logistic regression was used to adjust for differences in patient characteristics and derive adjusted outcomes. Level I and II teaching institutions in the NTDB. All patients with trauma admitted to a Level I or II teaching institution between January 1, 2002 and June 30, 2003 and between January 1, 2007 and December 31, 2008. Although overall adjusted in-hospital mortality was decreased (adjust...Continue Reading
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Brain Injury & Trauma
brain injury after impact to the head is due to both immediate mechanical effects and delayed responses of neural tissues.