Influence of Daily Variations in Individual Surgeon's Operative Time on Patient Outcomes
| Autor: | Etienne Meunier, Cécile Payet, Jean-Louis Kraimps, Frederic Sebag, Jean Christophe Lifante, Fabrice Menegaux, François Pattou, Jean-Louis Peix, Antoine Duclos |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Hypoparathyroidism medicine.medical_treatment Operative Time 030230 surgery 03 medical and health sciences 0302 clinical medicine Postoperative Complications medicine Humans Aged Surgeons business.industry Thyroidectomy Vascular surgery Middle Aged medicine.disease Confidence interval Surgery Cardiac surgery Cardiothoracic surgery 030220 oncology & carcinogenesis Female business Complication Vocal Cord Paralysis Abdominal surgery |
| Zdroj: | World journal of surgery. 43(11) |
| ISSN: | 1432-2323 |
| Popis: | Evidence is lacking regarding the potential association between daily variation in individual surgeon’s operative time, procedure after procedure, and risk of patient complication. We assumed that surgeon deviation from the expected procedure duration may be harmful for patient. All patients who underwent a thyroidectomy undertaken in five hospitals during a 1-year period were included prospectively. For each thyroidectomy, we estimated the expected operative time from a multilevel linear regression considering the attending surgeon who performed the operation, the patient preoperative risk, and the procedure complexity. Three groups of thyroidectomies were identified according to whether the observed duration is: slower than expected, as expected, or faster than expected. Rates of permanent recurrent laryngeal nerve palsy and hypoparathyroidism at 6 months were then compared between these groups. A total of 3102 patients who underwent a thyroidectomy undertaken by 22 surgeons were considered. Risk of laryngeal nerve palsy was higher in the “slow” group than in the “normal” group (OR = 4.63, 95% confidence interval 2.21–9.70), as was that of hypoparathyroidism (OR = 2.43, 95% confidence interval 1.21–4.88). There was no significant difference between “fast” and “normal” groups for either complication. Deviation from expected procedure duration was more frequent at the end than at the beginning of the daily operation schedule (29.4% vs. 18.3%, respectively, P |
| Databáze: | OpenAIRE |
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