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01-05-2008 | Healthcare Policy and Outcomes

Impact of Surgeon Training on Outcomes After Resective Hepatic Surgery

Authors: Andrew McKay, MD, FRCSC, Isabelle You, MSc, David Bigam, MD, FRCSC, Rene Lafreniere, MD, FRCSC, Francis Sutherland, MD, FRCSC, William Ghali, MD, MPH, FRCPC, Elijah Dixon, MD, MSc, BSc, FRCSC, FACS

Published in: Annals of Surgical Oncology | Issue 5/2008

Abstract

Background

Higher hospital and surgeon volumes have been associated with improved outcomes after hepatic resection. Subspecialty training has not previously been associated with improved outcomes after hepatic resection. The objective of this study was to determine what effects, if any, surgeon’s volume and training had on the outcomes after hepatic resection.

Methods

Administrative procedure codes were used to identify all adult patients from the fiscal year 1991–1992 to 2003–2004 who underwent a hepatic resection in two large urban health regions in Canada (Calgary and Capital health regions). The primary outcomes were operative mortality and postoperative complications.

Results

There were 1107 hepatic resections in the stated time period performed by a total of 72 surgeons. There were 66 deaths, resulting in an in-hospital mortality rate of 6.0%, and an overall complication rate of 46%. Statistically significant predictors of operative mortality were: urgency of admission, diagnosis of primary hepatic malignancy, extent of resection, and increasing burden of comorbid medical illness. Surgeon training along with patient’s sex, the urgency of admission, diagnosis of primary hepatic malignancy, extent of resection, and increasing comorbidity were predictive of postoperative complications.

Conclusions

This study found surgeon training to be highly predictive of postoperative complications after hepatic resection.

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Title: Impact of Surgeon Training on Outcomes After Resective Hepatic Surgery
Authors: Andrew McKay, MD, FRCSC
Isabelle You, MSc
David Bigam, MD, FRCSC
Rene Lafreniere, MD, FRCSC
Francis Sutherland, MD, FRCSC
William Ghali, MD, MPH, FRCPC
Elijah Dixon, MD, MSc, BSc, FRCSC, FACS
Publication date: 01-05-2008
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 5/2008
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-008-9838-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Impact of Surgeon Training on Outcomes After Resective Hepatic Surgery

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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