PD02-06 EFFECT OF RESIDENT INVOLVEMENT IN UROLOGICAL SURGERY ON SHORT-TERM PATIENT OUTCOMES: A META-ANALYSIS AND SYSTEMATIC REVIEW

Abstract

You have accessJournal of UrologyEducation Research I (PD02)1 Sep 2021PD02-06 EFFECT OF RESIDENT INVOLVEMENT IN UROLOGICAL SURGERY ON SHORT-TERM PATIENT OUTCOMES: A META-ANALYSIS AND SYSTEMATIC REVIEW Nazia Hossain, Hussien Mohamed, and Avi-Chai Robinson Nazia HossainNazia Hossain More articles by this author , Hussien MohamedHussien Mohamed More articles by this author , and Avi-Chai RobinsonAvi-Chai Robinson More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001966.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The effect on patient outcomes with and without resident involvement in urological surgery remains controversial. This study aims to systematically determine the effect of resident involvement on patient outcomes in urological surgery. METHODS: This paper followed the Preferred Reporting Items of Systematic Reviews and Meta-Analyses guidelines. Two independent reviewers searched PubMed, Embase, and the Cochrane Library to find studies assessing the impact of resident involvement on patient outcomes in urology cases. Eight patient variables were compared between cohorts to investigate participant similarity. Fifteen outcome variables potentially impacted by resident involvement were compared via meta-analysis. Study quality was assessed using the Newcastle-Ottawa Scale for cohort analysis and given a quality label based on Agency for Healthcare Research and Quality standards. Several papers relied on data from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), which reports 30-day patient outcomes. Sensitivity analysis was done to assess for patient overlap between papers that used ACS-NSQIP data. RESULTS: Fifteen studies were included in the meta-analysis, comprising a total of 95,326 patients. The resident-involved group had an overall lower amount of patients with diabetes (odds ratio [OR], 0.84; [95% CI], [0.74, 0.94]), hypertension ([OR], 0.84; [95% CI], [0.82, 0.87]) and smoking ([OR], 0.81; [95% CI], [0.76, 0.86]). Residents were also less involved in operations where patients had a Class 3 or 4 American Society of Anesthesiologists (ASA) scores ([OR], 0.96; [95% CI], [0.93, 1.00]). However, the resident-involved group had more negative post-operative outcomes. The resident-involved surgery group had higher rates of postoperative septic ([OR], 1.37; [95% CI], [1.16, 1.62]) and deep vein thrombosis (DVT) ([OR], 1.36; [95% CI], [1.07, 1.74]). The resident group also had longer operative times when results were reported dichotomously ([OR], 1.78; [95% CI], [1.64, 1.93]). CONCLUSIONS: Based on the results, resident involvement in urological surgery seems to have a negative effect on patient outcomes, specifically increased rates of septic shock, DVT and longer operative time despite resident involvement in cases with healthier patients. However, the data is limited due to the lack of high-quality, propensity-scored studies. Source of Funding: N/A © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e39-e39 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nazia Hossain More articles by this author Hussien Mohamed More articles by this author Avi-Chai Robinson More articles by this author Expand All Advertisement Loading ...