Impact of resident involvement on urological surgery outcomes: An analysis of 40,000 patients from the ACS NSQIP database

Richard S. Matulewicz, Matthew Pilecki, Aksharananda Rambachan, John Y.S. Kim, Shilajit D. Kundu*

*Corresponding author for this work

Research output: Contribution to journalArticle

41 Scopus citations

Abstract

Purpose In addition to excellent patient care, the focus of academic medicine has traditionally been resident training. The changing landscape of health care has placed increased focus on objective outcomes. As a result, the surgical training process has come under scrutiny for its influence on patient care. We elucidated the effect of resident involvement on patient outcomes. Materials and Methods We retrospectively analyzed data from the 2005 to 2011 NSQIP® participant use database. Patients were separated into 2 cohorts by resident participation vs no participation. The cohorts were compared based on preoperative comorbidities, demographic characteristics and intraoperative factors. Confounders were adjusted for by propensity score modification and complications were analyzed using perioperative variables as predictors. Results A total of 40,001 patients met study inclusion criteria. Raw data analysis revealed that cases with resident participation had a higher rate of overall complications. However, after propensity score modification there was no significant difference in overall, medical or surgical complications in cases with resident participation. Resident participation was associated with decreased odds of overall complications (0.85). Operative time was significantly longer in cases with resident participation (159 vs 98 minutes). Conclusions Urology resident involvement is not associated with increased overall and surgical complications. It may even be protective when adjusted for appropriate factors such as case mix, complexity and operative time.

Original languageEnglish (US)
Pages (from-to)885-890
Number of pages6
JournalJournal of Urology
Volume192
Issue number3
DOIs
StatePublished - Sep 2014

Keywords

  • complications
  • internship and residency
  • outcome assessment (health care)
  • quality of health care
  • urology

ASJC Scopus subject areas

  • Urology

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