Surgical outcomes based on resident involvement: what is the impact on vascular surgery patients?

Central to the education of future surgeons is residency which involves training and learning on patients. We examined the quality of surgical outcomes of vascular patients when residents were involved in their surgical case.

A retrospective review was conducted using the data from the American College of Surgeons National Surgical Quality Improvement Program from the 2010 year vascular surgery patient cases. Statistical analysis was used to compare the cases with and without residents involved.

There were a total of 363,431 from which we analyzed 2829 vascular surgery patients. Of those cases, 88% had a resident involved. Postgraduate year (PGY) 1 or 2 residents were involved in 12% and senior residents (PGY ≥ 3) were involved in 88% of surgeries. Preoperative pneumonia, cerebral vascular accident, dialysis, and smoking were significantly higher preoperative risk factors in the cases without the resident. Most of the patients were an American Society of Anesthesiology class III. Twenty-six percent of the patients were diabetic. The most common postoperative occurrences included transfusion requirement, postoperative pneumonia, and surgical site infections. Surgical site infections were the most common postoperative complication (4.6%). Cases with the resident involved had significantly more postoperative blood transfusions and on average took 15 more minutes to finish surgeries. A PGY 7 resident was predictive of prolonged hospital stay. The 30-day survival in the cases that had residents was 3.8% significantly higher compared with the cases that did not have residents.

Resident involvement in surgeries does not significantly worsen surgical outcomes.