Outcomes of physician patients after non-cardiac surgery: a registry analysis.

Autor: Panjasawatwong K; Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, 9500 Euclid Ave P77, Cleveland, OH, 44195, USA., Lin P; Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, 9500 Euclid Ave P77, Cleveland, OH, 44195, USA., Karimi N; Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, 9500 Euclid Ave P77, Cleveland, OH, 44195, USA., You J; Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, 9500 Euclid Ave P77, Cleveland, OH, 44195, USA.; Departments of Quantitative Health Science, Cleveland Clinic, 9500 Euclid Ave P77, Cleveland, OH, 44195, USA., Sessler DI; Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, 9500 Euclid Ave P77, Cleveland, OH, 44195, USA. DS@OR.org.
Jazyk: angličtina
Zdroj: Journal of anesthesia [J Anesth] 2017 Feb; Vol. 31 (1), pp. 111-119. Date of Electronic Publication: 2016 Oct 31.
DOI: 10.1007/s00540-016-2273-3
Abstrakt: Objectives: When physicians become patients, they may expect special privileges, extra attention from caregivers, and non-routine treatments. Consequently, physician patients may not be treated per routine-which possibly worsens care rather than improving it. We thus tested the primary hypothesis that in-hospital mortality and major complications after non-cardiac surgery are more common in physician patients than in non-physician patients.
Patients and Methods: Perioperative data were extracted for patients who had non-cardiac surgery at the Cleveland Clinic between 2005 and 2013. We used propensity score matching to identify comparable groups of physician and non-physician patients. Matched physician and non-physician patients were compared on a composite of in-hospital mortality and major postoperative complications using a generalized equation average relative effects model. Secondly, the matched patients were also compared on reoperation using logistic regression and on duration of hospitalization using Kaplan-Meier analysis with the log-rank test and Cox proportional hazards regression.
Results: Among 21,173 qualifying patients, we matched 522 physician patients to 2448 non-physician controls. There were no significant differences between physician and non-physician patients in the composite of in-hospital mortality and major complications, with an estimated odds ratio across the outcome components (average relative effect) of 1.20 (95% confidence interval 0.77-1.87) for physicians vs. non-physicians, P = 0.41. There was also no difference in the risk of re-operation or duration of hospitalization.
Conclusions: A variety of important outcomes were similar in physician patients and matched non-physician patients after non-cardiac surgery.
Databáze: MEDLINE
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