Impact of the Resident Physician Staffing Disruptions on Outcomes of Out-of-Hospital Cardiac Arrest: A Multicenter Retrospective Observational Study

Objective: In February 2024, following the announcement of new government healthcare policies, over 90% of resident physicians in South Korea submitted their resignations. This unprecedented staffing disruption raised concerns regarding its potential impact on the care of critically ill patients, particularly those with out-of-hospital cardiac arrest (OHCA). This study evaluated the effect of resident physician staffing disruptions on in-hospital management and outcomes of patients with OHCA. Methods: We conducted a multicenter retrospective observational study of adult patients (≥18 years) with OHCA of medical etiology in a metropolitan city during two periods: a comparison period (March 1-December 31, 2023) and a staffing disruption period (March 1-December 31, 2024). The primary outcomes were survival to hospital discharge and favorable neurologic outcome, defined as a Cerebral Performance Category score of 1-2. Multivariable logistic regression was used to assess the association between study period and outcomes. Results: A total of 1,516 patients were included (736 in the comparison period and 780 in the staffing disruption period). Baseline characteristics and rates of in-hospital interventions, including percutaneous coronary intervention, targeted temperature management, and extracorporeal membrane oxygenation, were similar between groups. The adjusted odds ratios for favorable neurologic outcome and survival to discharge during the staffing disruption period were 1.05 (95% CI, 0.64-1.74) and 1.26 (95% CI, 0.85-1.88), respectively. Conclusion: Short-term outcomes of patients with OHCA were not significantly affected by resident physician staffing disruptions. These findings suggest that emergency care for OHCA may have been preserved during the observed period.