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. 2020 Dec;22(4):245-257.
doi: 10.7461/jcen.2020.E2020.06.001. Epub 2020 Dec 14.

Does work time limit for resident physician affect short-term treatment outcome and hospital length of stay in patients with spontaneous intracerebral hemorrhage?: a two-year experience at a single training hospital in South Korea

Rojin Heo  1 , Cheol Wan Park  1   2 , Chan Jong You  1   2 , Dae Han Choi  1   2 , Kwangwoo Park  1   2 , Young Bo Kim  1 , Woo Kyung Kim  1 , Gi-Taek Yee  1 , Myeong-Jin Kim  1 , Jin-Hwan Oh  3
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Does work time limit for resident physician affect short-term treatment outcome and hospital length of stay in patients with spontaneous intracerebral hemorrhage?: a two-year experience at a single training hospital in South Korea

Rojin Heo et al. J Cerebrovasc Endovasc Neurosurg. 2020 Dec.

Abstract

Objective: To compare short-term treatment outcomes at hospital discharge and hospital length of stay (LOS) in patients with spontaneous intracerebral hemorrhage (sICH) before and after introduction of resident physician work time limit (WTL).

Methods: We retrospectively reviewed consecutive patients treated for sICH at our institution between 2016 and 2019. Then we dichotomized these patients into two groups, pre-WTL and post-WTL. We analyzed demographic elements and clinical features, and hospital length of stay (LOS). We evaluated short-term outcome using modified Rankin scale score at hospital discharge and then divided it into "good" and "poor" outcome groups. We subsequently, compared short-term treatment outcome and hospital LOS between the pre-WTL and post-WTL groups.

Results: Out of 779 patients, 420 patients (53.9%) were included in the pre-WTL group, and 359 (46.1%) in post-WTL. The mortality rate in sICH patients was higher in the post-WTL group (pre-WTL; 13.6% vs. post-WTL; 17.3%), but there was no statistically significant difference in short-term outcome including mortality (p=0.332) between the groups. The LOS also, was not significantly different between the two groups (pre-WTL; 19.0 days vs. post-WTL; 20.2 days) (p=0.341). The initial Glasgow Coma Scale score, personal stroke history, and mean age were the only independent outcome predicting factors for patients with sICH.

Conclusions: Some neurosurgeons may expect poorer outcome for sICH after implementation of the WTL of the K-MHW for resident physician however, enforcement of the WTL did not significantly influence the short-term outcome and hospital LOS for sICH in our hospital. Further well-designed multi-institutional prospective studies on the effects of WTL in sICH patient outcome, are anticipated.

Keywords: Length of stay; Mortality; Outcome; Resident; Work hour restriction.

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References

    1. Alaraj A, Hussein AE, Esfahani DR, Amin-Hanjani S, Aletich VA, Charbel FT. Reducing length of stay in aneurysmal subarachnoid hemorrhage: A three year institutional experience. J Clin Neurosci. 2017 Aug;42:66–70. - PubMed
    1. Ansari SF, Yan H, Zou J, Worth RM, Barbaro NM. Hospital length of stay and readmission rate for neurosurgical patients. Neurosurgery. 2018 Feb;82(2):173–81. - PubMed
    1. Babu R, Thomas S, Hazzard MA, Friedman AH, Sampson JH, Adamson C, et al. Worse outcomes for patients undergoing brain tumor and cerebrovascular procedures following the ACGME resident duty-hour restrictions. J Neurosurg. 2014 Aug;121(2):262–76. - PMC - PubMed
    1. Broderick JP, Adeoye O, Elm J. Evolution of the modified Rankin Scale and its use in future stroke trials. Stroke. 2017 Jul;48(7):2007–2012. - PMC - PubMed
    1. Browne JA, Cook C, Olson SA, Bolognesi MP. Resident duty-hour reform associated with increased morbidity following hip fracture. J Bone Joint Surg Am. 2009 Sep;91(9):2079–85. - PubMed