Department of Surgery, Duke University Medical Center, Durham, NC, USA.
Ann Surg. 2012 Mar;255(3):577-82. doi: 10.1097/SLA.0b013e3182468ed9.
To determine whether resident participation impacts complication rates after appendectomy.
The effect of resident participation on postoperative outcomes has not been well defined.
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.
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.
Resident participation represents an independent risk factor for postoperative complications after appendectomy.
确定住院医师参与是否会影响阑尾切除术后的并发症发生率。
住院医师参与对术后结果的影响尚未得到很好的定义。
使用 2005 年至 2009 年国家外科质量改进计划参与者用户文件中的数据，评估阑尾切除术中住院医师参与与术后并发症发生率之间的关系。多变量逻辑回归分析用于调整患者合并症、手术入路和阑尾疾病严重程度的影响。还进行了类似的分析，以确定参与手术的住院医师的研究生培训水平是否会影响阑尾切除术后的结果。
共有 54467 例阑尾切除术纳入本分析。住院医师参与是阑尾切除术后发生主要并发症的独立危险因素[校正比值比 1.27（95%可信区间 1.14-1.42），P < 0.0001]。参与的住院医师的资历越高，手术时间越长，术后并发症发生率越高。
住院医师参与是阑尾切除术后发生术后并发症的独立危险因素。
