Resident Duty-Hour Reform Associated with Increased Morbidity Following Hip Fracture
Journal of Bone and Joint SurgeryPublished 1 September 2009
James A. Browne, Chad Cook, Steven A. Olson, Michael P. Bolognesi
Citations59
SJR quartileQ1
SJR score1.67
SNIP1.95
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
A significant increase in the rate of change in the incidence of perioperative pneumonia, hematoma, transfusion, renal complications, nonroutine discharge, costs, and length of stay was seen in patients who underwent treatment for a hip fracture in the years after the resident duty-hour reforms at teaching institutions.
Abstract
Resident duty-hour reform was associated with an accelerated rate of increasing patient morbidity following treatment of hip fractures in teaching institutions. Further research into this concerning finding is needed.
Keywords
MedicineEconomics, Econometrics and Finance
Journal of Chronic DiseasesA new method of classifying prognostic comorbidity in longitudinal studies: Development and validation
49,938 Citations1987Mary E. Charlson, Peter Pompei +2 more
The method of classifying comorbidity provides a simple, readily applicable and valid method of estimating risk of death fromComorbid disease for use in longitudinal studies and further work in larger populations is still required to refine the approach.
Journal of Clinical EpidemiologyAdapting a clinical comorbidity index for use with ICD-9-CM administrative databases
10,426 Citations1992Richard A. Deyo
It is concluded that the adapted comorbidity index will be useful in studies of disease outcome and resource use employing administrative databases.
New England Journal of MedicineEffect of Reducing Interns' Work Hours on Serious Medical Errors in Intensive Care Units
1,759 Citations2004Christopher P. Landrigan, Jeffrey M. Rothschild +9 more
Sociological Methods & ResearchComparing Logit and Probit Coefficients Across Groups
1,041 Citations1999Paul D. Allison
Annals of Internal MedicineDoes Housestaff Discontinuity of Care Increase the Risk for Preventable Adverse Events?
671 Citations1994Laura A. Petersen, Troyen A. Brennan +3 more
The relation between housestaff coverage and potentially preventable adverse events in hospitalized patients using previously tested self-report methods was studied.
JAMANew Requirements for Resident Duty Hours
520 Citations2002Ingrid Philibert
A systematic review of the effectiveness of critical appraisal skills training for clinicians and the impact of an evidence-based medicine curriculum based on adult learning theory on students' reading habits and knowledge is presented.
International Journal of EpidemiologyUse of comorbidity scores for control of confounding in studies using administrative databases
411 Citations2000Sebastian Schneeweiß, Malcolm Maclure
Comorbidity scores, particularly the CDS or D'Hoore's CI based on three-digit ICD-9 codes, may be useful in exploratory data analysis, however, residual confounding by comorbidities is inevitable, given how these scores are derived.
JAMAMortality Among Hospitalized Medicare Beneficiaries in the First 2 Years Following ACGME Resident Duty Hour Reform
323 Citations2007Kevin G. Volpp, Amy K. Rosen +7 more
The ACGME duty hour reform was not associated with either significant worsening or improvement in mortality for Medicare patients in the first 2 years after implementation.
Archives of Internal MedicineTransfers of Patient Care Between House Staff on Internal Medicine Wards
293 Citations2006Leora I. Horwitz, Harlan M. Krumholz +2 more
Although transfers of care are increasingly frequent, few internal medicine residency programs have comprehensive transfer of care systems in place, and most do not provide formal training in sign-out skills to all residents.
JAMAMortality Among Patients in VA Hospitals in the First 2 Years Following ACGME Resident Duty Hour Reform
226 Citations2007Kevin G. Volpp, Amy K. Rosen +7 more
Journal of Vascular SurgeryMortality Among Patients in VA Hospitals in the First 2 Years Following ACGME Resident Duty Hour Reform
223 Citations2008Kevin G. Volpp, Amy K. Rosen +1 more
The ACGME duty hour reform was associated with significant relative improvement in mortality for patients with 4 common medical conditions in more teaching-intensive VA hospitals in postreform year 2.
Annals of Internal MedicineChanges in Hospital Mortality Associated with Residency Work-Hour Regulations
175 Citations2007Kanaka Shetty, Jayanta Bhattacharya
Limiting residents' work hours was associated with lower in-hospital mortality rates for medical patients in teaching hospitals, and this finding suggested that duty-hours caps improve patient outcomes, but the sample size was too small to show effects on mortality.
Journal of General Internal MedicinePost-call transfer of resident responsibility
123 Citations1990Richard P. Lofgren, Daniel J. Gottlieb +2 more
Patients transferred to a different resident the day after admission had more laboratory tests performed and longer inpatient stays.
PubMedReducing resident work hours: unproven assumptions and unforeseen outcomes.
106 Citations2004Mitchell Charap
Annals of Internal MedicineChanges in Outcomes for Internal Medicine Inpatients after Work-Hour Regulations
93 Citations2007Leora I. Horwitz, Mikhail Kosiborod +2 more
This study compared changes in the rates of 7 clinical measures over a 2-year period for patients discharged from a teaching service that followed the ACGME work-hour rules to changes for patients discharge from a nonteaching hospitalist service, a retrospective cohort study at YaleNew Haven Hospital.
New England Journal of MedicineA Precarious Exchange
80 Citations2004Siddhartha Mukherjee
If an anthropologist were to stumble into this room between 6 and 8 p.m. this evening, he might find the telltale signs of a ritual: a group of residents and interns huddled around a table, scribbl...
Journal of Surgical ResearchDoes Resident Hours Reduction Have an Impact on Surgical Outcomes?1
72 Citations2005Haytham M.A. Kaafarani, Kamal M.F. Itani +3 more
The restricted resident work hour schedule in general and vascular surgery in the DeBakey Houston Veteran Affairs Medical Center did not significantly affect postoperative outcomes.
Obstetrics and GynecologyThe Effect of House Staff Working Hours on the Quality of Obstetric and Gynecologic Care
70 Citations2004Jennifer L. Bailit, May Hsieh Blanchard
Although problems in physician performance may be underreported, resident work-hour restrictions show minimal evidence of improvement in quality of care.
New England Journal of MedicineAwake and Informed
54 Citations2004Jeffrey M. Drazen
I grew up with the one-doctor–one-patient paradigm, and as my practice migrated more toward intensive care medicine, in which the approach to care is more team oriented, I retained a remnant of the old habits.
The American Journal of SurgeryThe effect of a rotating night-float coverage scheme on preventable and potentially preventable morbidity at a level 1 trauma center
46 Citations2005Paul J. Schenarts, Josie Bowen +6 more
Limitation of resident work hours had no effect on length of hospital or ICU stay, ventilator days, or mortality, and work-hour restrictions did not increase or decrease the total number of complications nor did it alter the distribution of those determined to be preventable or potentially preventable.
Current SurgeryMyths and Realities of the 80-Hour Work Week
35 Citations2006Paul J. Schenarts, Kimberly D. Schenarts +1 more
Despite strongly held opinions, resident work-hour reduction has resulted in little significant change in lifestyle, clinical exposure, patient well-being, faculty work hours, or medical student recruitment.
CirculationEffect of Short Call Admission on Length of Stay and Quality of Care for Acute Decompensated Heart Failure
30 Citations2008Jennifer L. Schuberth, Tom A. Elasy +5 more
Admission to short call is predictive of increased length of stay, a decreased number of diuretic doses, and delays in the timing of diUREtic doses among patients with acute decompensated heart failure.
Journal of Bone and Joint SurgerySymposium Resident Work-Hour Guidelines<sbt aid="971631">A Sentence or An Opportunity for Orthopaedic Education?<cross-ref type="fn" refid="fn1">*</cross-ref></sbt>
26 Citations2005Vincent D. PellegriniJr.
The American Journal of MedicineEffects of end-of-month admission on length of stay and quality of care among inpatients with myocardial infarction
24 Citations2002James P. Smith, Rajendra H. Mehta +6 more
Although admission during the last 3 days of the month is an independent predictor of length of stay, it does not have a large effect on quality of care among patients with myocardial infarction.
