Does participation of surgery residents in carotid endarterectomy influence morbidity and mortality?: Analysis of 8 years of American College of Surgeons National Surgical Quality Improvement database entries.

Abstract

ObjectiveThis article aims to address the question of whether learner involvement in operative procedures produces a negative impact on morbidity and mortality. Our hypothesis is that learner participation will not affect outcomes. MethodsThis paper analyzes the outcomes of American College of Surgeons National Surgical Quality Improvement Program data entries from 2007 to 2012 of patients undergoing carotid endarterectomy. The analysis stratifies procedures based on first whether a resident was involved in a case, and then by their year in training. ResultsThere is no significant increase in morbidity or mortality of patients undergoing carotid endarterectomy when a learner is present. The higher the trainee's level of training, the longer the operative time was for the procedure; this factor was statistically significant. ConclusionsResident or fellow participation does not increase morbidity or mortality. This finding in context of dwindling autonomy for trainees for a multitude of reasons gives credence to allowing residents to participate more in the operative theater. These data could be used as justification for earlier involvement as well as more junior residents also saw no increase in complication.