Bariatric surgery outcomes when assisted by fellows and residents: an MBSAQIP analysis of 477,670 patients
| Autor: | Iain H. McKillop, Abdelrahman Nimeri, Selwan Barbat, Enayetur Raheem, Kyle J. Thompson, Nicholas Dugan |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Sleeve gastrectomy medicine.medical_specialty medicine.medical_treatment Deep vein Gastric Bypass Bariatric Surgery 030209 endocrinology & metabolism Accreditation 03 medical and health sciences 0302 clinical medicine Gastrectomy medicine Humans Retrospective Studies business.industry Incidence (epidemiology) medicine.disease Thrombosis Quality Improvement Surgery Pulmonary embolism Obesity Morbid medicine.anatomical_structure Treatment Outcome Propensity score matching Surgery outcome 030211 gastroenterology & hepatology Female business Body mass index |
| Zdroj: | Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery. 16(5) |
| ISSN: | 1878-7533 |
| Popis: | Background Previous reports of bariatric surgery outcomes when cases are assisted by residents and/or fellows have been inconclusive. Objective To compare bariatric surgery outcomes for cases with surgical trainees (ST; residents and fellows) versus nonsurgical trainees (nST; all other assistants) using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) Registry. Setting Academic teaching. Methods The MBSAQIP Registry was reviewed (2015–2017) for Roux-en-Y gastric bypass, sleeve gastrectomy, and revision surgery based on ST and nST status. Univariate, multivariate logistic regression, and propensity matching analyses were performed. Results Of 477,670 cases, 26.8% were performed with ST. For ST patients 79.9% were female (versus 80.3% nST) and mean body mass index was 45.2 ± 8 kg/m2 (versus 45.0 ± 8.1 kg/m2 nST). Overall, 31.7% of patients underwent Roux-en-Y gastric bypass (versus 25.7% nST), 65.9% underwent sleeve gastrectomy (versus 71.6% nST), and 2.4% of patients had revision surgery (versus 2.7% nST). After matching, no difference in 30-day mortality was observed between groups. However, ST patients had higher incidence of deep vein thrombosis (P = .004), pulmonary embolism (P = .005), superficial surgical site infection (P Conclusion Overall, there was no difference observed in 30-day mortality between the ST and nST groups. However, despite lower 30-day reoperation rates, ST patients exhibited higher rates of postoperative deep vein thrombosis, pulmonary embolism, superficial surgical site infection, postoperative sepsis, blood transfusions, 30-day readmission rates, and longer operative times than nST patients. |
| Databáze: | OpenAIRE |
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