TY - JOUR
T1 - Impact of resident participation in surgical operations on postoperative outcomes
T2 - National surgical quality improvement program
AU - Kiran, Ravi Pokala
AU - Ahmed Ali, U.
AU - Coffey, John C.
AU - Vogel, Jon D.
AU - Pokala, Naveen
AU - Fazio, Victor W.
PY - 2012/9
Y1 - 2012/9
N2 - Objective: To evaluate whether resident participation in operations influences postoperative outcomes. Background: Identification of potential differences in outcome associated with resident participation in operations may facilitate planning from educational and health resource perspectives. Methods: From the National Surgical Quality Improvement Program database (2005-2007), postoperative outcomes were compared for patients with and without resident participation (RES vs no-RES). Groups were matched in a 2:1 ratio, based on age, sex, specialty, surgical procedure, morbidity probability, and important comorbidities and risk factors. Results: RES (40,474; 66.7%) and no-RES (20,237; 33.3%) groups were comparable for matched characteristics. Mortality was similar (0.18% vs 0.20%, P = 0.55). Thirty-day complications classified as mild (4.4% vs 3.5%, P < 0.001) and surgical (7% vs 6.2%, P < 0.001) were higher in RES group. Individual complications were largely similar, except superficial surgical site infection (3.0% vs 2.2%, P < 0.001). Operative time was longer in the RES group [mean (SD) 122 (80) vs 97 (67) minutes, P < 0.001]. Overall complications were lower for postgraduate year 1-2 residents than for other years. These differences persisted on multivariate analysis adjusting for confounders. Conclusions: Resident involvement in surgical procedures is safe. The small overall increase in mild surgical complications is mostly caused by superficial wound infections. Reasons for this are likely multifactorial but may be related to prolonged operative time.
AB - Objective: To evaluate whether resident participation in operations influences postoperative outcomes. Background: Identification of potential differences in outcome associated with resident participation in operations may facilitate planning from educational and health resource perspectives. Methods: From the National Surgical Quality Improvement Program database (2005-2007), postoperative outcomes were compared for patients with and without resident participation (RES vs no-RES). Groups were matched in a 2:1 ratio, based on age, sex, specialty, surgical procedure, morbidity probability, and important comorbidities and risk factors. Results: RES (40,474; 66.7%) and no-RES (20,237; 33.3%) groups were comparable for matched characteristics. Mortality was similar (0.18% vs 0.20%, P = 0.55). Thirty-day complications classified as mild (4.4% vs 3.5%, P < 0.001) and surgical (7% vs 6.2%, P < 0.001) were higher in RES group. Individual complications were largely similar, except superficial surgical site infection (3.0% vs 2.2%, P < 0.001). Operative time was longer in the RES group [mean (SD) 122 (80) vs 97 (67) minutes, P < 0.001]. Overall complications were lower for postgraduate year 1-2 residents than for other years. These differences persisted on multivariate analysis adjusting for confounders. Conclusions: Resident involvement in surgical procedures is safe. The small overall increase in mild surgical complications is mostly caused by superficial wound infections. Reasons for this are likely multifactorial but may be related to prolonged operative time.
KW - residency
KW - surgery
KW - training
UR - http://www.scopus.com/inward/record.url?scp=84865476716&partnerID=8YFLogxK
U2 - 10.1097/SLA.0b013e318265812a
DO - 10.1097/SLA.0b013e318265812a
M3 - Article
C2 - 22842127
AN - SCOPUS:84865476716
SN - 0003-4932
VL - 256
SP - 469
EP - 475
JO - Annals of Surgery
JF - Annals of Surgery
IS - 3
ER -