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Defining the Impact of Resident Participation on Outcomes After Appendectomy

2012; Lippincott Williams & Wilkins; Volume: 255; Issue: 3 Linguagem: Inglês

10.1097/sla.0b013e3182468ed9

1528-1140

John Scarborough, Kyla M. Bennett, Theodore N. Pappas,

Appendicitis Diagnosis and Management

In Brief Objective: To determine whether resident participation impacts complication rates after appendectomy. Background: The effect of resident participation on postoperative outcomes has not been well defined. Methods: Data from the National Surgical Quality Improvement Program Participant User File from 2005 through 2009 were used to assess the association between resident participation during appendectomy and postoperative complication rates. Multivariate logistic regression analysis was used to adjust for patient comorbidity, surgical approach, and severity of appendiceal disease. Similar analyses were performed to determine whether outcomes after appendectomy are influenced by the postgraduate training level of the participating surgical resident. Results: A total of 54,467 appendectomy procedures were included in our analysis. Resident participation was an independent risk factor for major complications [adjusted odds ratio 1.27 (95% CI 1.14–1.42), P < 0.0001] after appendectomy. Increasing seniority of the participating resident was associated with longer operative time and higher postoperative complications rates. Conclusions: Resident participation represents an independent risk factor for postoperative complications after appendectomy. We investigated the effect of surgical resident participation during appendectomy on postoperative morbidity using the National Surgical Quality Improvement Program Participant User File. We found that risk-adjusted postoperative complication rates are significantly higher in procedures performed with resident participation, and that the incidence of postoperative complications increases with increasing resident seniority.