Denver Health Medical Center, University of Colorado School of Medicine, USA.
Indiana University School of Medicine, USA.
Am J Surg. 2019 Dec;218(6):1181-1184. doi: 10.1016/j.amjsurg.2019.08.023. Epub 2019 Sep 19.
Burnout and depression is higher in trauma surgeons as compared to surgeons in other specialties. Clinical practice for many acute care surgeons (ACS) includes in-house call (IHC). The goal of this study was to quantitate physiologic stress among ACS who take IHC.
ACS with IHC responsibilities from two Level I trauma centers were studied. Participants wore a fitness and heart rate variability (HRV) device over 3 months. HRV was categorized as normal if 85% of baseline, moderate stress when HRV <85% but >50%, and high stress when HRV< 50%.
1421 nights were recorded among 17 surgeons (35.3% female; mean age 45.5 years). Excluding IHC, mean HRV = 32.23, and 95.63% of days were consistent with moderate or high stress. Post-call day 2 had significantly highest percentage of high stress (65.82%, p = 0.0495). High and moderate stress levels returned to baseline on post-call day 3.
High and moderate stress beyond IHC is common among ACS. Future study is needed to determine consequences of persistent stress and identify factors which impact recovery after IHC.
与其他外科专业相比，创伤外科医生的倦怠和抑郁发生率更高。许多急性护理外科医生（ACS）的临床实践包括院内值班（IHC）。本研究的目的是量化接受 IHC 的 ACS 中的生理应激。
研究了来自两个一级创伤中心的有 IHC 责任的 ACS。参与者在 3 个月内佩戴健身和心率变异性（HRV）设备。如果基线的 85%，则 HRV 正常；如果 HRV<85%但>50%，则为中度压力；如果 HRV<50%，则为高度压力。
17 名外科医生（35.3%为女性；平均年龄 45.5 岁）共记录了 1421 个夜晚。不包括 IHC，平均 HRV=32.23，95.63%的日子处于中度或高度压力状态。值班后第 2 天的高度压力百分比显著最高（65.82%，p=0.0495）。值班后第 3 天，高压力和中度压力水平恢复到基线。
ACS 接受 IHC 后，高度和中度压力很常见。需要进一步研究以确定持续压力的后果，并确定影响 IHC 后恢复的因素。
