Michigan Bariatric Surgery Collaborative, Ann Arbor, MI.
Department of Surgery, Henry Ford Health System, Detroit, MI.
Ann Surg. 2018 May;267(5):905-909. doi: 10.1097/SLA.0000000000002297.
This study sought to explore the relationship of bariatric surgeon age and patient outcomes.
Regulators, policy makers, and patient advocacy groups have recently been pushing to establish clear guidelines for physician retirement in the United States. Although it is often assumed that increasing physician age leads to worse patient outcomes, the relationship is lacking robust evidence, and is still unclear.
We conducted a study analyzing all bariatric surgeons in Michigan who participated in a statewide collaborative quality improvement program (n = 71) who performed primary laparoscopic Roux-en-Y Gastric Bypass, or sleeve gastrectomy operations, and data on their patients (n = 60430) over the past 10 years. Our primary outcomes were 30-day postoperative complications. Odds ratios for overall complications and serious complications were calculated for each age group, and surgery type.
Late career surgeons had more bariatric surgery experience and had a higher average annual case volume than early career surgeons. Considering all cases in the past 10 years, older surgeons performed more Roux-en-Y Gastric Bypass (40%) and less sleeve gastrectomy (38.8%) than younger surgeons (34.7% and 51.5%). When adjusting for patient and surgeon characteristics, there were no statistically significant differences in overall or serious complication rates for either procedure among surgeon age groups.
When evaluating bariatric surgeons in the State of Michigan, we found no statistically significant association between surgeon age and patient outcomes. Our findings do not provide evidence for age-specific retirement cut-offs, but support the development of guidelines which are holistic, and focus on evaluating and improving physician outcomes at all career levels.
本研究旨在探讨肥胖症外科医生年龄与患者结局之间的关系。
监管机构、政策制定者和患者权益团体最近一直在推动在美国建立明确的医生退休指导方针。尽管人们普遍认为，医生年龄的增加会导致患者结局恶化，但这种关系缺乏强有力的证据，目前仍不清楚。
我们进行了一项研究，分析了在密歇根州参与全州合作质量改进计划的所有肥胖症外科医生（n=71），他们实施了原发性腹腔镜 Roux-en-Y 胃旁路手术或袖状胃切除术，以及他们的患者数据（n=60430）在过去 10 年中的数据。我们的主要结局是术后 30 天的并发症。计算了每个年龄组和手术类型的总并发症和严重并发症的比值比。
晚期职业生涯的外科医生具有更多的减肥手术经验，并且平均每年的手术量高于早期职业生涯的外科医生。考虑到过去 10 年中的所有病例，老年外科医生实施的 Roux-en-Y 胃旁路手术（40%）多于年轻外科医生（34.7%），而袖状胃切除术（38.8%）少于年轻外科医生（51.5%）。在调整了患者和外科医生特征后，在手术年龄组之间，两种手术的总并发症或严重并发症发生率均无统计学差异。
在评估密歇根州的肥胖症外科医生时，我们没有发现外科医生年龄与患者结局之间存在统计学显著关联。我们的研究结果没有提供年龄特定退休截止点的证据，但支持制定整体指南，重点评估和改善所有职业水平的医生的结局。
