ArticleAnnals of medicine and surgery (2012)2020
Do new trainees pose a threat to postoperative complications after hip fracture surgeries? Retrospective cohort of 1045 patients over a decade at a university hospital.
Article in Annals of medicine and surgery (2012), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors at 3 institutions in 2 countries.
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Abstract
introductionInduction of new residents and surgical trainees in most institutes occurs once a year. Fresh residents with no experience, may pose a threat to the surgical procedure outcome and there can be a potential increase in patients' morbidity and mortality as a result of this turnover. Literature is inconclusive about this effect. Our aim was to study the "new residents' induction effect" on postoperative complications after hip fracture surgeries. METHODOLOGY: This is non funded non commercialized study from a university hospital. Investigators studied a retrospective cohort of 1045 adult hip fracture patients who were operated at our tertiary care and level 1 trauma centre of a metropolitan city between 2008 and 2018. We defined primary exposure as the time period of new resident's induction (January-March) with the primary outcome in-hospital and 30days postoperative complications. Cox proportional hazard algorithm analysis was done at univariate and multivariable levels reporting Crude Relative Risk (RR) and Adjusted Relative Risk (aRR), respectively. Results were reported in line with STROBE criteria.
resultsThere were 274 (26%) patients in exposed group out of whom 109 (40%) developed postoperative complications. Interestingly, patients who had their surgeries during the induction period of new residents had 8% less risk of developing postoperative complications. However, result was statistically insignificant at both univariate and multivariable levels with RR; 95% C.I of 0.9 (0.78-1.22) and aRR; 95% C.I of 0.9 (0.78-1.22) after adjusting for the all other independent variables.
conclusionThe association of new residents' induction on postoperative hip fracture surgery complications, although protective, was insignificant after controlling for the potential confounding effect of patients' background and demographic characteristics. We recommend further multi-centre high powered studies to analyze this.
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