Surgeon Gender and Early Complications in Elective Surgery: A Systematic Review and Meta-analysis

To examine the association between surgeon gender and early postoperative complications, including 30-day death and readmission, in elective surgery.

Variations between male and female surgeon practice patterns may be a source of bias and gender inequality in the surgical field, perhaps impacting the quality of care. However, there are limited and conflicting studies regarding the association between surgeon gender and postoperative outcomes.

MEDLINE and Embase were searched in October 2023 for observational studies, including patients who underwent elective surgery requiring general or regional anesthesia across multiple surgical specialties. Multiple independent blinded reviewers oversaw the data selection, extraction, and quality assessment according to the PRISMA, MOOSE, and Newcastle Ottawa Scale guidelines. Data were pooled as odds ratios, using a generic inverse-variance random-effects model.

Of 944 abstracts screened, 11 studies were included in this systematic review and meta-analysis. A total of 4,440,740 postoperative patients were assessed for a composite primary outcome of mortality, readmission, and other complications within 30 days of elective surgery, with a total of 325,712 (7.3%) surgeries performed by 7072 (10.9%) female surgeons. There was no association between surgeon gender and the composite of mortality, readmission, and/or complications (odds ratio=0.97, 95% CI 0.95-1.00; I2 =64.9%; P =0.001).

These results support that surgeon gender is not associated with early postoperative outcomes, including mortality, readmission, or other complications in elective surgery. These findings encourage patients, health care providers, and stakeholders not to consider surgeon gender as a risk factor for postoperative complications.