Short-term outcome following cardiac surgery--a comparison between consultant and trainees' performance

Comparison of the outcome of cardiac operations performed by surgical trainees with those performed by consultant surgeons has been an interesting topic in recent years. We set out to examine the outcome of a high volume-training firm. Cardiac operations performed by surgical trainees and a consultant between January 2006 and March 2009 were studied. Hospital mortality and morbidity were compared in the two groups. Eight hundred and seventy-two operations were performed, 687 (79%) were operated by consultant and 185 (21%) by surgical trainees. Mean logistic EuroSCORE in consultant and surgical trainees groups was 3.7 and 2.7, respectively (P<0.001). One hundred and forty-two (77%) of the cases performed by trainees were coronary artery bypass grafting (CABG). Interestingly, the ratio of urgent cases was higher in the trainees group [156 (23%) compared to 59 (32%), P=0.004]. Mortality in consultant and surgical trainees groups for all operations was 18 (2.6%) and six (3.2%), respectively (P=NS). Mortality for CABG in consultant and surgical trainees groups was six (1.7%) and six (4.2%), respectively (P=NS). There was no significant difference in morbidity outcome measures comparing the two groups. The non-significant higher overall mortality in operations performed by trainees in a fully supervised setting, may reflect the influence of experience and confidence, which are difficult to measure.