Context: In their first year of postgraduate training, interns commonly work shifts that are longer than 24 hours. Extended-duration work shifts are associated with increased risks of automobile crash, particularly during a commute from work. Interns may be at risk for other occupation-related injuries.
Objective: To assess the relationship between extended work duration and rates of percutaneous injuries in a diverse population of interns in the United States.
Design, Setting, And Participants: National prospective cohort study of 2737 of the estimated 18,447 interns in US postgraduate residency programs from July 2002 through May 2003. Each month, comprehensive Web-based surveys that asked about work schedules and the occurrence of percutaneous injuries in the previous month were sent to all participants. Case-crossover within-subjects analyses were performed.
Main Outcome Measures: Comparisons of rates of percutaneous injuries during day work (6:30 am to 5:30 pm) after working overnight (extended work) vs day work that was not preceded by working overnight (nonextended work). We also compared injuries during the nighttime (11:30 pm to 7:30 am) vs the daytime (7:30 am to 3:30 pm).
Results: From a total of 17,003 monthly surveys, 498 percutaneous injuries were reported (0.029/intern-month). In 448 injuries, at least 1 contributing factor was reported. Lapse in concentration and fatigue were the 2 most commonly reported contributing factors (64% and 31% of injuries, respectively). Percutaneous injuries were more frequent during extended work compared with nonextended work (1.31/1000 opportunities vs 0.76/1000 opportunities, respectively; odds ratio [OR], 1.61; 95% confidence interval [CI], 1.46-1.78). Extended work injuries occurred after a mean of 29.1 consecutive work hours; nonextended work injuries occurred after a mean of 6.1 consecutive work hours. Injuries were more frequent during the nighttime than during the daytime (1.48/1000 opportunities vs 0.70/1000 opportunities, respectively; OR, 2.04; 95% CI, 1.98-2.11).
Conclusion: Extended work duration and night work were associated with an increased risk of percutaneous injuries in this study population of physicians during their first year of clinical training.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1001/jama.296.9.1055 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Distal Humerus Physeal Separation: Diagnostic Challenges and Implications.
Cureus
December 2024
Orthopaedics and Traumatology, Universiti Putra Malaysia, Serdang, MYS.
Distal humerus physeal separation is an uncommon and often misdiagnosed injury in infants and young children, frequently resulting in delayed treatment. We report three cases of distal humerus physeal separation that presented with different clinical scenarios with different management approaches. The first case describes a nine-month-old girl who was initially treated for presumed elbow cellulitis before presentation to our centre six weeks later.
View Article and Find Full Text PDFDynamic coronary roadmap-guided PCI reduces contrast volume and radiation time compared to standard angiography PCI: A meta-analysis.
Heliyon
January 2025
Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen.
Background: Dynamic Coronary Roadmap (DCR) is a new PCI method that may reduce contrast dose and contrast-associated acute kidney injury (CA-AKI) risk. This paper evaluates DCR-guided PCI versus standard angiography PCI for contrast usage, procedure time, and CA-AKI risk.
Methods: On May 1, 2024, we searched PubMed, Scopus, Embase, Cochrane Library, and clinicaltrials.
Multifidus fat infiltration negatively influences the postoperative outcomes in lumbar disc herniation following transforaminal approach percutaneous endoscopic lumbar discectomy.
Eur J Med Res
January 2025
Department of Orthopedic Surgery, Jiujiang University Clinical Medical College (Jiujiang University Affiliated Hospital), Jiujiang, 332006, China.
Purpose: This study aims to investigate the influence of multifidus muscle fat infiltration on clinical outcomes in lumbar disc herniation (LDH) undergoing percutaneous endoscopic lumbar discectomy (PELD).
Methods: A retrospective analysis was conducted on 224 patients who underwent lateral PELD, with complete one-year follow-up data. Patients were divided into two groups based on preoperative MRI evaluation of L4 multifidus muscle fat infiltration: a mild group (< 25%) and a severe group (≥ 25%).
A relevant investigation of the degree of cement diffusion after robot-assisted percutaneous vertebroplasty.
BMC Musculoskelet Disord
January 2025
Department of Spine Surgery, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, 210003, China.
The aim of this research was to conduct randomized trials assessing the extent of cement diffusion following robot-assisted percutaneous vertebroplasty (R-PVP) for osteoporotic vertebral compression fractures (OVCF). A total of 96 OVCF patients meeting the inclusion criteria and admitted between January 2023 and November 2023 were included in the study. Among them, 48 patients were assigned to the robotic-assisted PVP group (R-PVP group) and 48 patients were assigned to the traditional PVP group (PVP group).
View Article and Find Full Text PDFProne Transpsoas Lumbar Interbody Fusion for Degenerative Disc Disease.
JBJS Essent Surg Tech
January 2025
Department of Neurosurgery, Center for Neuroscience and Spine, Virginia Mason Medical Center, Seattle, Washington.
Background: Prone transpsoas lumbar interbody fusion (PTP) is a newer technique to treat various spinal disc pathologies. PTP is a variation of lateral lumbar interbody fusion (LLIF) that is performed with the patient prone rather than in the lateral decubitus position. This approach offers similar benefits of lateral spinal surgery, which include less blood loss, shorter hospital stay, and quicker recovery compared with traditional open spine surgery.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!