関連する実験動画
夜間処置を行った後の医師の診察による合併症のリスク
Jeffrey M Rothschild1, Carol A Keohane, Selwyn Rogers
1Division of General Medicine and Primary Care, Brigham and Women's Hospital, 1620 Tremont St, Boston, MA 02120-1613, USA. jrothschild@partners.org
JAMA
|October 15, 2009
まとめ
夜間手術後の医師の睡眠不足は,全体的に患者の合併症率を有意に増加させなかった. しかし,睡眠時間が6時間未満の外科医は,より高い合併症リスクに直面しました.
科学分野:
- 医学研究 医学研究
- 外科手術の結果について
- 患者の安全性について
背景:
- 医者の労働時間と睡眠が患者の安全性に与える影響に関するデータは限られている.
- 医師の疲労と医療ミスとの関係を理解することは極めて重要です.
研究 の 目的:
- 外科医や産婦人科医の睡眠機会と,患者の合併症のリスクとの関連性を調査する.
- 夜勤の後に行われる処置における合併症率を分析する.
主な方法:
- 1999年から2008年にかけて,主治医 (外科医,産婦人科医) が実施した手順を分析したマッチングされた遡及コホート研究が行われました.
- 睡眠の機会は,夜間の処置と後の処置の間の時間として定義されました.
- 合併症は,盲目,多段階のレビュープロセスを用いて評価されました.
主要な成果:
- 総合的な合併症率は,夜間手術後の処置と対照群 (5.4%対4.9%) の間で類似していました.
- 睡眠時間が6時間未満の医師が実施した処置では,合併症率が6.2% (3.4%) 高いことが示されました.
- 12時間以上またはそれ未満の作業と比較して,12時間以上の作業後の手順では,合併症の有意な増加は観察されなかった.
結論:
- 診察医が一晩働いた翌日に実施された処置は,全体的に合併症率が著しく高かったとは関連づけられませんでした.
- 睡眠機会が6時間未満の医師による夜間の外科手術後の合併症率が増加することが示されました.
- 発見は,夜間の通話の後の手術を行う外科医の睡眠制限に関連した潜在的なリスクを示唆しています.
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