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Risk of Complications Does Not Increase If Physicians Work Overnight
Jeffrey M. Rothschild, M.D., M.P.H., of Brigham and Women's Hospital, Boston, presented the findings of the study at a JAMA media briefing in Chicago.
There has been increasing public attention on the role of resident physicians' fatigue in the occurrence of medical errors. In 2003, work hour limits were implemented for resident physicians in the U.S. Work hours of attending physicians are not restricted. "Little is known about the frequency of elective surgical and obstetrical/gynecologic procedures by attending physicians who participate in emergency procedures the night before. Even less is known about the risks of complications during these postnighttime procedures," according to background information in the article.
Dr. Rothschild and colleagues examined the relationship between nighttime work hours, sleep, and rates of complications in procedures performed the next day. The researchers analyzed data on procedures performed from January 1999 through June 2008 by attending physicians (86 surgeons and 134 obstetricians/gynecologists) who had been in the hospital performing another procedure involving adult patients for at least part of the preceding night (12 a.m.- 6 a.m., postnighttime procedures). A total of 919 surgical and 957 obstetrical postnighttime procedures were matched with 3,552 and 3,945 control procedures, respectively. Control procedures included those of the same type performed by the same physician on days without preceding overnight procedures.
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