Association of Acute Care Surgeon Experience with Emergency
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This JAMA study states that acute care surgeons may benefit from additional mentorship during the initial stages of their careers.

The aim of this study was to evaluate the association of acute care surgeon experience with patient morbidity and mortality after emergency surgical procedures.

This cohort study evaluated the association of surgeon experience with emergency surgery outcomes at 5 US academic level 1 trauma centers where the same surgeons provided emergency general surgical care. A total of 772 patients who presented with a traumatic injury and required an emergency surgical procedure or who presented with or developed a condition requiring an emergency general surgical intervention were operated on by 1 of 56 acute care surgeons.

Surgeon groups were divided by experience of fewer than 6 years (early career), 6 to 10 years (early midcareer), 11 to 30 years (late midcareer), and 30 years or more (late-career) from the end of training. Surgeons with less than 3 years of experience were also compared with the entire cohort. Hierarchical logistic regression models were constructed controlling for Emergency Surgery Score, case complexity, preoperative transfusion, and trauma or emergency general surgery.

Of 772 included patients, 469 were male. Of 772 operations, 618 were by surgeons with less than 10 years of experience.

--Early- and late-midcareer surgeons generally operated on older patients and patients with more septic shock, acute kidney failure, and higher Emergency Surgery Scores.

--Patient mortality, complications, postoperative transfusion, organ-space surgical site infection, and length of stay were similar between surgeon groups.

--Patients operated on by early-career surgeons had higher rates of unplanned return to the operating room compared with those operated on by early-mid career surgeons, late-mid-career surgeons, and late-career surgeons.

--Patients operated on by surgeons with less than 3 years of experience had similar mortality compared with the rest of the cohort but higher rates of complications.

In this study, experienced surgeons generally operated on older patients with more septic shock and kidney failure without affecting risk-adjusted mortality. Increased complications and unplanned return to the operating room may improve with experience. Early-career surgeons’ outcomes may be improved if they are supported while experience is garnered.

Source: https://jamanetwork.com/journals/jamasurgery/article-abstract/2776952
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