Trauma Complications Increase as Residents' Work Hours Decrease

LOS ANGELES -- When surgical residents were limited to an 80-hour workweek there was a significant increase in the rate of complications-but no increase in deaths-at an academic level I trauma center here.

LOS ANGELES, Aug. 22 -- When surgical residents were limited to an 80-hour workweek there was a significant increase in the rate of complications -- but no increase in deaths -- at an academic level I trauma center here.

In the two years after the work hour reforms, trauma patients were 29% more likely to experience complications and the overall complication rate was 7.29% compared with the 5.64% rate before residents' work hours were limited (P

Moreover, there were twice as many missed injuries after work hours were limited, but this difference was not statistically significant.

Because there was an increase in both preventable and nonpreventable complications, the authors acknowledged that there may be factors other than work limitations -- problems with data collection, for instance -- that could explain the observed increase. And since mortality did not increase "the increased complication rate could be viewed as a transient phenomenon."

But the "doubling of missed injuries (though not statistically significant) is worrisome," they concluded.