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Tytuł:
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Effect of Resident Involvement on Morbidity and Mortality Following Thoracic Endovascular Aortic Repair.
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Autorzy:
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Acheampong DO; Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York.
Paul P; Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York.
Guerrier S; Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York.
Boateng P; Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York.
Leitman IM; Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address: .
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Źródło:
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Journal of surgical education [J Surg Educ] 2018 Nov; Vol. 75 (6), pp. 1575-1582. Date of Electronic Publication: 2018 Apr 30.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Original Publication: New York, N.Y. : Elsevier
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MeSH Terms:
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Endovascular Procedures*
Internship and Residency*
Aortic Aneurysm, Thoracic/*surgery
Postoperative Complications/*mortality
Aged ; Clinical Competence ; Female ; Humans ; Male ; Morbidity ; Postoperative Complications/epidemiology ; Treatment Outcome
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Contributed Indexing:
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Keywords: Medical Knowledge; Patient Care; Practice-Based Learning and Improvement; Systems-Based Practice; endovascular; outcome; resident; thoracic aortic aneurysm; thoracic aortic dissection
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Entry Date(s):
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Date Created: 20180501 Date Completed: 20191210 Latest Revision: 20220330
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Update Code:
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20240104
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DOI:
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10.1016/j.jsurg.2018.04.012
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PMID:
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29709469
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Objective: To evaluate the effect of resident involvement in thoracic endovascular aortic repair (TEVAR).
Summary of Background Data: Although the influence of resident intraoperative involvement in several types of surgical procedures has been reported, the effect of resident participation in TEVAR is unknown. We evaluated patient outcomes in resident-involved TEVAR procedures.
Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was analyzed for TEVAR performed from 2010 to 2012. Current procedural terminology codes were used to identify adult patients (≥18 y) who underwent TEVAR. Patients were grouped into those with and without resident involvement. Descriptive and binomial logistic statistics were used to determine the effect of resident involvement on post-TEVAR outcomes. p values < 0.05 were considered statistically significant.
Results: A total of 676 patients met inclusion criteria for this study. Of these, 517 (76.5%) had residents involved. Overall mortality was 9.8%, with no significant difference between the 2 groups (p = 0.88). Resident involvement was not a significant predictor of any post-TEVAR complication. Postoperative pneumonia (3.5% vs 6.9%, p = 0.06), prolonged mechanical ventilation (11.8% vs 11.9%, p = 0.96), stroke (2.7% vs 5.7%, p = 0.07), urinary tract infection (3.3% vs 4.4%, p = 0.50), progressive renal insufficiency (1.2% vs 2.5%, p = 0.22), acute renal failure (4.1% vs 5.0%, p = 0.60), cardiac arrest (2.9% vs 5.0%, p = 0.20), myocardial infarction (1.7% vs 1.9%, p = 0.91), deep venous thrombosis (1.7% vs 1.3%, p = 0.67), red blood cells transfusions (29.2% vs 36.5%, p = 0.08), sepsis (2.9% vs 4.4%, p = 0.35), septic shock (1.9% vs 3.8%, p = 0.18), and unplanned reintubation (8.7% vs 9.4%, p = 0.78) were not significantly affected. Additionally, resident involvement did not significantly affect operative time (176.1 ± 122.8 min vs 180.3 ± 119.1 min, p = 0.71) and anesthesia time (282.1 ± 146.6 min vs 278.3 ± 140.5 min, p = 0.78).
Conclusions: The participation of residents in TEVAR did not significantly affect all 30-day patient outcomes. Resident involvement in TEVAR is safe and should be encouraged.
Mini Abstract: This study evaluated the effect of resident participation on postoperative outcomes of thoracic endovascular aortic repair (TEVAR) using the American College of Surgeons National Surgical Quality Improvement (ACS-NSQIP) database. Results showed that resident involvement in TEVAR does not negatively affect patient outcomes.
(Copyright © 2018. Published by Elsevier Inc.)