The impact of surgical training on early and long-term outcomes after isolated aortic valve surgery
| Autor: | Shubhra Sinha, Gianni D Angelini, Arnaldo Dimagli, Umberto Benedetto, Massimo Caputo |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Medical education
Pulmonary and Respiratory Medicine medicine.medical_specialty Surgical training Bristol Heart Institute surgical education Transcatheter Aortic Valve Replacement Aortic valve replacement Risk Factors medicine Long term outcomes Humans In patient aortic valve replacement Hospital Mortality Cardiac Surgical Procedures Propensity Score Eacts/113 Retrospective Studies Heart Valve Prosthesis Implantation Surgical education AcademicSubjects/MED00920 business.industry General surgery EuroSCORE Aortic Valve Stenosis General Medicine medicine.disease Risk perception Treatment Outcome Heart Valve Prosthesis Aortic Valve Propensity score matching Aortic valve surgery Surgery Cardiology and Cardiovascular Medicine business medical education surgical training Conventional Valve Operations Eacts/125 |
| Zdroj: | Benedetto, U, Dimagli, A, Sinha, S, Caputo, M & Angelini, G D 2021, ' The impact of surgical training on early and long-term outcomes after isolated aortic valve surgery ', European Journal of Cardio-Thoracic Surgery, vol. 61, no. 1, ezab328 . https://doi.org/10.1093/ejcts/ezab328 European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery |
| Popis: | OBJECTIVES Patients presenting with more comorbidities, requiring more complex cardiac surgical procedures and an increase in public scrutiny are impacting on training programme because of the perceived risk of worse outcomes. Hence, we aimed to provide evidence that trainees as the first operator can achieve comparable results to consultants when performing isolated surgical aortic valve replacement. METHODS From 1996 to 2017, 2919 patients underwent surgical aortic valve replacement at the Bristol Heart Institute, operated on by either a consultant (n = 2220) or a trainee (n = 870) as the first operator. Propensity score matching was used to adjust for imbalance in the baseline characteristics of the 2 groups. RESULTS Over a 21-year period, the proportion of trainee cases dropped from 41.5% to 25.9%. No differences in the rates and risk of in-hospital mortality, new cerebrovascular accidents, re-exploration for bleeding, deep sternal wound infection and length of stay were found between patients operated on in the 2 groups. Also, there was a comparable risk of late death between the 2 groups (HR 0.88; 95% CI 0.73–1.06; P = 0.27) and this was present regardless of trainees career level and patients surgical risk based on the EuroSCORE. Finally, we showed an increase in patients risk profile in the latest year but, this was not associated with the worst outcomes when trainees performed the operation. CONCLUSIONS Surgical aortic valve replacement is a safe and reproducible technique and regardless of the patient’s risk profile, and no differences in the outcomes between trainees and consultant cases were found. Over the few past years, research in surgical education has bloomed and attention has been drawn to the quality and quantity of surgical training. |
| Databáze: | OpenAIRE |
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