Document Detail


Short- and midterm outcomes of coronary artery bypass surgery performed by surgeons in training.
MedLine Citation:
PMID:  19379972     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The effect of training on outcomes in cardiac surgery is poorly studied. We aimed to study the results of coronary artery bypass grafting procedures performed by surgeons in training across our state with respect to short- and midterm postoperative outcomes. METHODS: All coronary artery bypass grafting surgeries performed by trainee surgeons between July 2001 and December 2006 were compared with those performed by consultant surgeons using mandatory prospectively collected statewide data. Early mortality; prolonged ventilation or intensive care unit stay; return to operating theater for bleeding, stroke, myocardial infarction, or renal failure; and 5-year survival were compared using propensity score analysis. RESULTS: A total of 7745 surgeries were included in this study. Trainees performed 983 (13%) surgeries. Trainee surgeries had longer perfusion and crossclamp times. Crude early postoperative outcomes were similar between trainee and consultant surgeries. After propensity score adjustment, early outcomes remained similar, with the exception of myocardial infarction (0.8% in trainee surgeries vs 0.4% in consultant surgeries, P = .046). Adjusted 1-, 3-, and 5-year survivals were similar between trainee and consultant surgeries: 95.3% versus 95.5%, 90.8% versus 92.0%, and 86.3% versus 87.1%, respectively. CONCLUSION: Coronary artery bypass grafting performed by trainee surgeons within a supervised program is safe with acceptable short- and midterm outcomes.
Authors:
Cheng-Hon Yap; Nick Andrianopoulos; T Diem Dinh; Baki Billah; Alexander Rosalion; Julian A Smith; Gilbert C Shardey; Peter D Skillington; James Tatoulis; Morteza Mohajeri; Michael Yii; Chistopher M Reid
Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-03-17
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  137     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-04-21     Completed Date:  2009-05-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1088-92     Citation Subset:  AIM; IM    
Affiliation:
Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia. chenghonyap@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Clinical Competence*
Confidence Intervals
Coronary Artery Bypass / methods*,  mortality*
Coronary Artery Bypass, Off-Pump / methods,  mortality
Coronary Disease / mortality,  surgery
Education, Medical, Graduate / methods
Female
Follow-Up Studies
Humans
Incidence
Internship and Residency*
Kaplan-Meiers Estimate
Male
Medical Staff, Hospital*
Middle Aged
Postoperative Complications / mortality
Probability
Proportional Hazards Models
Risk Assessment
Survival Analysis
Time Factors
Total Quality Management
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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