Defining the impact of resident participation on outcomes after appendectomy.

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.