Resident involvement in hand and upper extremity surgery: An analysis of 30-day complications.

Autor: Biron DR; Rutgers New Jersey Medical School Department of Orthopaedics, 140 Bergen Street, ACC D1610, Newark, NJ, 07103, United States., DalCortivo RL; Rutgers New Jersey Medical School Department of Orthopaedics, 140 Bergen Street, ACC D1610, Newark, NJ, 07103, United States., Ahmed IH; Rutgers New Jersey Medical School Department of Orthopaedics, 140 Bergen Street, ACC D1610, Newark, NJ, 07103, United States., Vosbikian MM; Rutgers New Jersey Medical School Department of Orthopaedics, 140 Bergen Street, ACC D1610, Newark, NJ, 07103, United States.
Jazyk: angličtina
Zdroj: Journal of clinical orthopaedics and trauma [J Clin Orthop Trauma] 2023 Nov 08; Vol. 45, pp. 102281. Date of Electronic Publication: 2023 Nov 08 (Print Publication: 2023).
DOI: 10.1016/j.jcot.2023.102281
Abstrakt: Background: Rotations in hand and upper extremity surgery are a core component of the Orthopaedic and Plastic Surgery resident training curriculums. This study compares short-term outcomes in hand and upper extremity procedures with and without resident involvement.
Methods: The National Surgical Quality Improvement Program database was queried from years 2005-2012 for all procedures distal to the shoulder. Patients were stratified based on whether a resident scrubbed for the procedure. Outcome measures were 30-day mortality, reoperation rate, minor complications, major complications, and length of stay (LOS). Chi-squared tests were used to determine significant variables. Significant variables were included in a binomial multivariate logistic regression model.
Results: A total of 7697 patients were included in the study. Of those, 4509 (59 %) had no resident, and 3188 (41 %) had a resident. Patients with resident involvement were less likely to be Caucasian, ASA classification 3 or higher, and outpatient. Cohorts were similar with respect to age, sex, and emergent status. Operative time was 15 min longer in resident cases. Work relative value units were higher in resident cases. In the multivariate logistic regression model, resident involvement had no statistically significant impact on LOS, mortality, reoperation rate, minor complications, or major complications. Subgroup analysis showed increased odds of superficial surgical site infections in resident cases, although this was statistically insignificant (OR 1.35, p = 0.24).
Conclusions: Hand and upper extremity procedures with resident involvement do not have any increase in overall adverse short-term outcomes. In appropriately selected cases, residents can participate without compromising patient safety.
Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Michael Vosbikian reports a relationship with Journal of Bone and Joint Surgery Inc that includes: consulting or advisory. Michael Vosbikian reports a relationship with ePlasty that includes: board membership.
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Databáze: MEDLINE
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