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Surgical resident involvement is safe for common elective general surgery procedures
Warren H Tseng1, Leah Jin, Robert J Canter
1Department of Surgery, Division of Surgical Oncology, University of California, Davis Medical Center, Sacramento, CA 95817, USA.
Journal of the American College of Surgeons
|April 16, 2011
Summary
Surgical resident involvement (SRI) impacts patient outcomes and operative time (OpT). While associated with increased morbidity, SRI significantly decreased mortality across general surgery procedures.
Area of Science:
- Surgical Education Research
- Patient Safety and Outcomes
Background:
- Surgical resident training outcomes are under scrutiny.
- The impact of surgical resident involvement (SRI) on operative parameters is not well-understood.
Purpose of the Study:
- To evaluate the effect of SRI on perioperative morbidity, mortality, and operative time (OpT).
- To examine 7 common general surgery procedures.
Main Methods:
- Utilized the American College of Surgeons National Surgical Quality Improvement Program database (2005-2007).
- Included 37,907 nonemergent operations, excluding simultaneous procedures.
- Performed logistic regression and Wilcoxon rank-sum tests, incorporating SRI, OpT, and risk-stratifying morbidity/mortality scores.
Main Results:
- 71.3% of cases involved SRI.
- SRI was associated with increased 30-day morbidity (3.0% vs 1.0%) and decreased mortality (0.1% vs 0.08%) across all procedures.
- Mean operative time was consistently lower for cases without SRI.
Conclusions:
- Surgical resident involvement significantly impacts 30-day morbidity, mortality, and operative time.
- Findings have implications for surgical graduate medical education.
- Further research is needed to identify morbidity causes and prevention strategies in teaching environments.
