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Updated: Apr 25, 2026
Emergency Undocking in Robotic Surgery: A Simulation Curriculum
Published on: May 20, 2018
Trainee participation is associated with adverse outcomes in emergency general surgery: an analysis of the National
George Kasotakis1, Aliya Lakha, Beda Sarkar
1Departments of *Surgery; and †Graduate Medical Sciences, Boston University School of Medicine, Boston, MA.
Objective:
To identify whether resident involvement affects clinically relevant outcomes in emergency general surgery.
Background:
Previous research has demonstrated a significant impact of trainee participation on outcomes in a broad surgical patient population.
Methods:
We identified 141,010 patients who underwent emergency general surgery procedures in the 2005-2010 Surgeons National Surgical Quality Improvement Program database. Because of the nonrandom assignment of complex cases to resident participation, patients were matched (1:1) on known risk factors [age, sex, inpatient status, preexisting comorbidities (obesity, diabetes, smoking, alcohol, steroid use, coronary artery disease, chronic renal failure, pulmonary disease)] and preoperatively calculated probability for morbidity and mortality. Clinically relevant outcomes were compared with a t or χ test. The impact of resident participation on outcomes was assessed with multivariable regression modeling, adjusting for risk factors and operative time.
Results:
The most common procedures in the matched cohort (n = 83,790) were appendectomy (39.9%), exploratory laparotomy (8.8%), and adhesiolysis (6.6%). Trainee participation is independently associated with intra- and postoperative events, wound, pulmonary, and venous thromboembolic complications, and urinary tract infections.
Conclusions:
Trainee participation is associated with adverse outcomes in emergency general surgery procedures.
