Wiser with Age? Increased Per-Surgeon Elderly Patient Volume is Associated with Lower Postinjury Complications
| Autor: | Marko Bukur, Joseph Catino, Joshua Simon, Quoc Dang, Elizabeth Warnack |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Critical Care Length of hospitalization law.invention 03 medical and health sciences Postoperative Complications 0302 clinical medicine law Humans Medicine Hospital Mortality 030212 general & internal medicine Practice Patterns Physicians' Elderly patient Aged Retrospective Studies Aged 80 and over business.industry Incidence Age Factors 030208 emergency & critical care medicine Retrospective cohort study General Medicine Length of Stay Middle Aged Intensive care unit Trauma Surgeon Surgery Patient volume Florida Wounds and Injuries Female business Trauma surgery Volume (compression) |
| Zdroj: | The American Surgeon. 84:1027-1032 |
| ISSN: | 1555-9823 0003-1348 |
| DOI: | 10.1177/000313481808400660 |
| Popis: | We hypothesize that higher elderly patient volume per trauma surgeon is associated with fewer clinical complications. This is a retrospective cohort study which included elderly patients admitted to trauma surgery service within a five-year period, from 2009 to 2013, at two Level I trauma centers in Florida. Trauma surgeons were stratified into three groups depending on patient volume. Primary outcomes were postinjury complications and in-hospital mortality, and secondary outcomes were hospital length of stay (LOS), intensive care unit LOS, and ventilator days. A total of 2379 elderly patients were included in this study. Elderly patient volume per surgeon did not significantly differ based on years in practice after fellowship (P = 0.88). The higher volume group had lower incidence of complications (15% complication rate, P = 0.02), compared with the average and low-volume group (18.1 and 21%, respectively), and had significantly lower rates of acute respiratory failure (P = 0.04) and acute renal failure (P = 0.004). In-hospital mortality was not affected by volume. Hospital LOS was decreased in the higher volume group (mean LOS 7.4 days, P < 0.001). There appears to be a relationship between elderly patient volume and outcome, independent of surgeon years of experience. |
| Databáze: | OpenAIRE |
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