Interdepartment of Critical Care Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 166, Gumi-ro, Bundang-gu, Seongnam, 463-707, Republic of Korea.
J Anesth. 2018 Apr;32(2):198-203. doi: 10.1007/s00540-018-2462-3. Epub 2018 Feb 5.
Controversy exists as to whether the physician turnover affects patient outcome in academic hospitals. In-hospital cardiopulmonary resuscitation (CPR) is an important indicator of in-hospital mortality. This study aimed to investigate whether the physician turnover is associated with the in-hospital CPR rate.
This retrospective cohort study was conducted at a single center; all in-hospital CPR cases among in-patients from 1 January 2007 to 31 December 2016 were analyzed. The turnover period was defined as the changeover of the trainee workforce in March, May, and November. The primary outcome was any variation in the monthly in-hospital CPR events (per 1000 admissions). The secondary outcomes were return of spontaneous circulation (ROSC), CPR in intensive care unit (ICU), monthly in-hospital deaths per 1000 admissions, and average length of hospital stay.
A total of 2182 in-hospital CPR cases were included in the analysis. Monthly in-hospital CPR rates were greater during the turnover period when compared to the non-turnover period (4.66 ± 1.02 vs. 4.18 ± 1.56, P = 0.027). There was no significant difference in ROSC rate, CPR in ICU rate, monthly in-hospital deaths per 1000 admissions, or average length of hospital stay between the two periods.
Our findings indicate that physician turnover may be associated with in-hospital CPR rate. However, physician turnover was not associated with ROSC rate, rate of CPR in the ICU, in-hospital death, or length of hospital stay.
关于医生更替是否会影响学术医院的患者预后，目前仍存在争议。院内心肺复苏（CPR）是院内死亡率的一个重要指标。本研究旨在探讨医生更替是否与院内 CPR 率相关。
本回顾性队列研究在单中心进行；分析了 2007 年 1 月 1 日至 2016 年 12 月 31 日期间所有住院患者的院内 CPR 病例。更替期定义为 3 月、5 月和 11 月的轮转人员更替期。主要结局为每月院内 CPR 事件（每千例入院）的任何变化。次要结局为自主循环恢复（ROSC）、重症监护病房（ICU）内 CPR、每月每千例入院死亡人数和平均住院时间。
共纳入 2182 例院内 CPR 病例。与非更替期相比，更替期每月院内 CPR 率更高（4.66±1.02 比 4.18±1.56，P=0.027）。两个时期的 ROSC 率、ICU 内 CPR 率、每月每千例入院死亡人数或平均住院时间无显著差异。
我们的研究结果表明，医生更替可能与院内 CPR 率相关。然而，医生更替与 ROSC 率、ICU 内 CPR 率、院内死亡或住院时间无关。
