Comparing Clinical Outcomes

Abstract

INTRODUCTION: Although the postoperative complications of cesarean delivery are well defined, studies have yet to identify if the rate of complications vary between attending and supervised resident surgeons. The purpose of this study was to determine whether the clinical outcome in elective cesarean delivery is less favorable when the operation is performed by a supervised resident surgeon. METHODS: Patients who underwent primary elective cesarean delivery at Winnie Palmer Hospital January to December 2012 were stratified into group I or II based on whether an attending or supervised resident surgeon was documented as performing the operation. Surgical length, postoperative complications, and length of hospital stay were collected. RESULTS: Of 359 cases, 286 were performed by an attending surgeon (group I) and 73 were performed by a supervised resident surgeon (group II). The rate of postoperative complications for group I and II was 3.5% and 8.2%, respectively, without statistical significance (P=.11). The median surgical length for group I and II was 39 and 54 minutes, respectively, with statistical significance (P<.001). The median length of hospital stay for group I and II was 4 and 3 days, respectively, with statistical significance (P<.001). CONCLUSION AND IMPLICATIONS: Patients undergoing elective cesarean delivery performed by a supervised resident surgeon are not more likely to experience postoperative complications than those operated on by an attending surgeon. On average, patients operated on by supervised resident surgeons have a 1-day shorter hospital stay. This finding is of most importance because longer hospital stays are associated with increased health care costs.