Surgeon Gender and Post-Operative In-Hospital Mortality

Abstract

Background: Prior studies report improved mortality rates for patients of female internists, few studies have evaluated the effect of surgeon gender on post-operative mortality. Methods: A retrospective analysis using the Agency for Health Care Administration Florida database from 2010-2015 examined patients undergoing one of 25 selected surgical procedures. Surgeon gender (self-reported), number of Medicare beneficiaries and years of experience were imported from CMS Physician Compare/Provider Utilization & Payment Data set using NPI. 25 procedures of varying complexity from all subspecialties were selected. For each procedure, inverse probability of treatment weighting (IPTW) was used to match cases performed by male vs female surgeons to achieve maximum balance between the groups. Results: There were 73,994 admissions for patients undergoing surgical procedures performed by 2,828 surgeons(361 females, 2467 males). Fewer patients who had emergent procedures performed by female surgeons died in the hospital(291/13957,2.08% vs 348/14017,2.48% p=0.026). Those who underwent the following procedures had significantly lower rates of in-hospital mortality if the surgeon was female: CABG(2/387,0.52% vs 8/387,2.07%), mastectomy(2/4797,0.04% vs 10/4797,0.21%), open cholecystectomy(7/955,0.73% vs 17/955, 1.78%) all p≤0.05. Conclusion: Patients who underwent CABG, mastectomy and open cholecystectomy had lower rates of in-hospital mortality if the surgeon was female while male surgeons did not have a significant mortality advantage for any procedure. Further studies examining national data may provide additional insight regarding the effect of surgeon gender on patient outcomes.