Alexander Bradley, Sowers Mackenzie, Jacob Roshan, McGwin Gerald, Maffulli Nicola, Naranje Sameer
Divisão de Cirurgia Ortopédica, Universidade do Alabama em Birmingham, Birmingham, Alabama, Estados Unidos.
Departamento de Epidemiologia, Universidade do Alabama em Birmingham, Universidade Boulevard Birmingham, Alabama, Estados Unidos.
Rev Bras Ortop (Sao Paulo). 2021 Nov 4;58(1):133-140. doi: 10.1055/s-0041-1736469. eCollection 2023 Feb.
The aim of the present study was to determine the influence of resident involvement on acute complication rates in revision total hip arthroplasty (THA). Using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database, 1,743 revision THAs were identified from 2008 to 2012; 949 of them involved a resident physician. Demographic information including gender and race, comorbidities including lung disease, heart disease and diabetes, operative time, length of stay, and acute postoperative complications within 30 days were analyzed. Resident involvement was not associated with a significant increase in the risk of acute complications. Total operative time demonstrated a statistically significant association with the involvement of a resident (161.35 minutes with resident present, 135.07 minutes without resident; < 0.001). There was no evidence that resident involvement was associated with a longer hospital stay (5.61 days with resident present, 5.22 days without resident; = 0.46). Involvement of an orthopedic resident during revision THA does not appear to increase short-term postoperative complication rates, despite a significant increase in operative times.
本研究的目的是确定住院医师参与对翻修全髋关节置换术（THA）急性并发症发生率的影响。使用美国外科医师学会国家外科质量改进计划（ACS - NSQIP）数据库，从2008年至2012年识别出1743例翻修THA；其中949例有住院医师参与。分析了包括性别和种族在内的人口统计学信息、包括肺病、心脏病和糖尿病在内的合并症、手术时间、住院时间以及术后30天内的急性并发症。住院医师参与与急性并发症风险的显著增加无关。总手术时间与住院医师的参与存在统计学上的显著关联（有住院医师在场时为161.35分钟，无住院医师时为135.07分钟；<0.001）。没有证据表明住院医师参与与更长的住院时间有关（有住院医师在场时为5.61天，无住院医师时为5.22天；=0.46）。尽管手术时间显著增加，但骨科住院医师参与翻修THA似乎并未增加术后短期并发症发生率。
