T. E. Newhook1, C. A. Guidry1, F. Turrentine1, R. Sawyer1, R. S. Jones1 1University Of Virginia,Surgery,Charlottesville, VA, USA
Introduction:
Studies suggest that increasing surgeon age worsens surgical outcomes following selected highly complex procedures. The influence of surgeon age outcomes in a diverse population of surgical patients remains uncertain. For that reason, we aimed to investigate the influence of surgeon time from initial board certification on a population of general and vascular surgery patients.
Methods:
We used the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database established at a tertiary care university hospital over a period of 10 years. The risk of NSQIP-defined complications or mortality was estimated for each patient by multivariable logistic regression utilizing variables identified by the NSQIP Risk Calculator, as well as albumin and operative year. Years of experience after American Board of Surgery (ABS) certification were calculated for each surgeon at the time of each operation. Multivariate linear regression with mixed effects modeling was used to determine the association between years of surgical practice and pre-operative risk of complications and mortality. Additional multivariate logistic regression was also used to evaluate the influence of surgeon years post-board certification on risk-adjusted patient outcomes. Statistical significance was set at a p < 0.01.
Results:
A total of 21,985 operations were included during the study period. Models for predicted complication and mortality rates performed well with C- statistics of 0.78 to 0.89. Years elapsed from initial ABS certification was predicted of both risk of any complication, as well as 30-day mortality (p < 0.001). There was a reduced operative risk as years from initial ABS certification increased. Moreover, an inverse correlation was observed between years after board certification and both predicted risk for any complication and 30-day mortality (Fig. 1). Importantly, after adjusting for risk, no association was observed between years from board certification and any complication or mortality.
Conclusion:
As surgeons aged they operated on patients having progressively fewer pre-operative risks for morbidity and mortality. There was no evidence that aging of surgeons resulted in increased morbidity or mortality.
