相关实验视频
在执行夜间手术后,主治医生的并发症风险
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
概括
在一夜间手术后,医生睡眠剥夺并没有显著增加患者的并发症率. 然而,睡眠时间少于6小时的外科医生面临更高的并发症风险.
科学领域:
- 医学研究 医学研究
- 外科手术的结果
- 患者安全 患者安全
背景情况:
- 关于医生工作时间和睡眠对患者安全的影响的数据有限.
- 了解医生疲劳和医疗错误之间的关系至关重要.
研究的目的:
- 调查外科医生和产科医生/妇科医生的睡眠机会与患者并发症风险之间的联系.
- 分析夜班后进行的手术中的并发症率.
主要方法:
- 一项匹配的回顾性队列研究分析了从1999年至2008年由主治医生 (外科医生,产科医生/妇科医生) 执行的程序.
- 睡眠机会被定义为一夜间手术和后续手术之间的时间.
- 用盲目的多步审查过程来评估并发症.
主要成果:
- 在过夜后的手术和对照组 (5.4%与4.9%) 之间,整体并发症率相似.
- 由医生进行的手术,睡眠时间少于6小时,并发症率更高 (6.2%对3.4%).
- 在工作时间超过12小时后的手术中,与12小时或更短的手术相比,没有观察到明显的并发症增加.
结论:
- 在主治医生一夜工作后的第二天进行的手术与明显更高的整体并发症率无关.
- 经过一夜间手术后,医生睡眠时间少于6个小时的医生发现并发症率增加.
- 调查结果表明,在一夜之间打电话后进行手术的外科医生睡眠不足可能存在潜在风险.
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