Anesthesiologist volume and short-term outcomes in Complex G
Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...
Intraoperative anesthesiology care is crucial to high-quality surgical care. The clinical expertise and experience of anesthesiologists may decrease the risk of adverse outcomes. This study supports organizing perioperative care to increase anesthesiologist volume and decrease the risk of adverse postoperative outcomes.

This JAMA study objective was to examine the association between anesthesiologist volume and short-term postoperative outcomes for complex gastrointestinal (GI) cancer surgery.

This population-based cohort study used administrative health care data sets from various data sources in Ontario, Canada. Adult patients who underwent esophagectomy, pancreatectomy, or hepatectomy for GI cancer, were eligible. Of the 8096 patients included, 5369 were men, and the median interquartile range [IQR]) age was 65 years. Operations were supported by 842 anesthesiologists and performed by 186 surgeons, and the median (IQR) anesthesiologist volume was 3 procedures per year.

The primary outcome was a composite of 90-day major morbidity (with a Clavien-Dindo classification grade 3-5) and readmission. A total of 2166 patients received care from high-volume anesthesiologists.

--The primary outcome occurred in 36.3% of patients in the high-volume group and 45.7% of patients in the low-volume group.

--After adjustment, care by high-volume anesthesiologists was independently associated with lower odds of the primary outcome, major morbidity, unplanned intensive care unit admission, but not readmission or mortality.

--E-values analysis indicated that an unmeasured variable would unlikely substantively change the observed risk estimates.

Conclusively, among adults who underwent complex gastrointestinal cancer surgery, those who received care from high-volume anesthesiologists had a lower risk of adverse postoperative outcomes compared with those who received care from low-volume anesthesiologists.