Stress among surgical attendings and trainees: A quantitative assessment during trauma activation and emergency surgeries.

BACKGROUND: The adverse effects of stress on the wellness of trauma team members is well established, however, the level of stress has never been quantitatively assessed. The aim of our study was to assess the level of stress using subjective data and objective heart rate variability (HRV) among attending surgeons (AS), junior (JR) (PGY2/PGY3), and senior (SR) (PGY5/PGY6) residents during trauma activation and emergency surgery. METHODS: We preformed a prospective study enrolling participants over eight 24-hour calls in our Level-1 trauma center. Stress was assessed based on decrease in heart rate variability (HRV), which was recorded using body worn sensors. Stress was defined as HRV below 85% of baseline HRV. We collected subjective data on stress for each participant during calls. Three groups (AS, JR, SR) were compared for duration of different stress levels through trauma activation and emergency surgery. RESULTS: A total of 22 participants (AS: 8, JR: 7, SR: 7) were evaluated over 192 hours, which included 33 trauma activations and 50 emergency surgeries. Stress level increased during trauma activations and operations regardless of level of training. The AS had significantly lower stress when compared to SR and JR during trauma activation (21.9+/-10.7 vs. 51.9+/-17.2 vs. 64.5+/-11.6; p

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