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Outcomes With Overlapping Surgery at a Large Academic Medical Center.

Brent A Ponce1, Bradley W Wills1, Parke W Hudson1

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Overlapping surgery (OS) is safe and efficient in training institutions. This study found OS did not increase patient risk for mortality, readmission, or complications compared to non-overlapping surgery.

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Area of Science:

  • Surgical outcomes research
  • Patient safety in academic medical centers

Background:

  • Overlapping surgery (OS) involves an attending physician supervising two concurrent surgeries.
  • Recent attention has focused on OS practices, patient consent, and safety concerns.

Purpose of the Study:

  • To evaluate the efficiency and safety of overlapping surgery (OS) versus non-overlapping surgery (NO) in a training institution.
  • To compare operative time, mortality, readmissions, and complications between OS and NO.

Main Methods:

  • Retrospective cohort study using population-based data from a tertiary academic center (2014-2015).
  • Included patients undergoing surgery by attending surgeons with ≥10% of cases overlapping.
  • Analyzed 30-day mortality, 30-day readmission, and 7 patient safety indicators (PSIs).

Main Results:

  • OS cases were longer (2.18 hours) than NO cases (1.64 hours) (P < 0.0001).
  • OS was associated with decreased mortality (RR 0.42), decreased readmission (RR 0.92), and decreased PSI occurrence (RR 0.67).
  • All results were statistically significant (P < 0.05).

Conclusions:

  • Overlapping surgery (OS) does not appear to increase patient risk.
  • Findings support prior research and address gaps concerning resident involvement and specialty-specific effects.
  • Further investigation is warranted, but current evidence suggests OS is safe.