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外科住院医师参与对颈动脉内膜切除术结果的影响。

The Impact of Surgery Resident Participation on the Outcome of Carotid Endarterectomy.

作者信息

Ammar Alex D

机构信息

University of Kansas School of Medicine-Wichita, Department of Surgery.

出版信息

Kans J Med. 2020 Jan 31;13:6-8. eCollection 2020.

Abstract

INTRODUCTION

The purpose of this study was to determine whether the in-hospital stroke rate plus deaths (SD) was adversely impacted by the participation of surgery residents during carotid endarterectomy.

METHODS

A single board-certified vascular surgeon performed 5,663 carotid endarterectomies (CEAs) from September 1982 through December 2016. The surgeon prospectively recorded the data used in this report during the patient's hospital stay. These cases were done at five hospitals, three of which had general surgery residents participating in procedures and two that did not.

RESULTS

Of the 5,663 CEAs, residents participated at three hospitals in 4,974 CEAs. In the two hospitals that did not have surgery residents participating, 689 CEAs were performed. Fifty-seven strokes and 12 deaths occurred in hospitals with resident participation (SD 1.39%). Six strokes (0.9%) and no deaths occurred in hospitals without resident participation. No significant difference in stroke rate, death rate, or combined stroke plus death rate (SD) were identified in comparing hospitals with or without resident participation.

CONCLUSION

This report corroborates others that senior general surgery residents did not have a significant impact on SD in patients undergoing CEA.

摘要

引言

本研究的目的是确定在颈动脉内膜切除术期间外科住院医师的参与是否会对院内卒中率加死亡率(SD)产生不利影响。

方法

一名获得单一委员会认证的血管外科医生在1982年9月至2016年12月期间进行了5663例颈动脉内膜切除术(CEA)。外科医生在患者住院期间前瞻性地记录了本报告中使用的数据。这些手术在五家医院进行,其中三家医院有普通外科住院医师参与手术,两家医院没有。

结果

在5663例CEA中,住院医师在三家医院参与了4974例CEA。在没有外科住院医师参与的两家医院中,进行了689例CEA。有住院医师参与的医院发生了57例卒中,12例死亡(SD为1.39%)。没有住院医师参与的医院发生了6例卒中(0.9%),无死亡病例。在比较有或没有住院医师参与的医院时,未发现卒中率、死亡率或卒中加死亡率(SD)有显著差异。

结论

本报告证实了其他研究结果,即普通外科住院医师对接受CEA治疗的患者的SD没有显著影响。

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