Can We Safely Train Cardiothoracic Surgical Residents to Perform Emergency Surgery? A 10-Year Propensity-Matched...

Area of Science:

• Cardiovascular Surgery
• Surgical Education
• Patient Safety

Background:

• Current cardiac surgical training faces challenges like work hour limits and complex cases.
• Ensuring high-quality training and patient safety in emergency settings is crucial.

Purpose of the Study:

• To compare outcomes of emergency adult cardiac surgery performed by residents versus consultants.
• To evaluate the effectiveness and safety of resident-led emergency cardiac procedures.

Main Methods:

• Retrieved data for 1241 emergency adult cardiac surgeries (2015-2024).
• Used 1:1 propensity-score matching for resident-led (R) and consultant-led (C) cases, creating 364 matched pairs.
• Compared in-hospital (mortality, complications, length of stay) and post-discharge (long-term survival) outcomes.

Main Results:

• Matched groups R and C had comparable demographics and preoperative risk.
• Cardiopulmonary bypass and aortic cross-clamp times were longer in consultant-led cases, suggesting greater complexity.
• No significant differences were found in in-hospital or post-discharge outcomes between resident-led and consultant-led groups.

Conclusions:

• Supervised resident-led emergency cardiac surgery yields outcomes comparable to consultant-led procedures.
• Findings support progressive autonomy for residents in emergency cardiac surgery under supervision.
• This approach ensures patient safety while preparing residents for independent practice.