Total Number Of Operations Research Articles

Quality of life and reconstructive surgery efforts in severe hand injuries.

Introduction:Severe hand trauma, leading to extensive skeletal and tissue defects, requires plastic surgical reconstruction of the highest level aiming at maximizing function and aesthetics. The intention of this study was to investigate clinical parameters and resource consumption connected with severe hand injuries, with specific emphasis on a follow-up evaluation of quality of life after the reconstruction process.Materials and methods:In this retrospective study, we evaluated patients with severe hand injuries from 2013 to 2016 who had completed surgical and non-surgical treatment. Measures included total period of therapy (TPT) in days, total duration of operations including anesthesia (TOA), total duration of all operations (TO), and total number of operations (TNO). We also determined total inpatient stay (TIS), total number of clinic presentations with interventions (TNPI), initial hand injury severity score (iHISS), and inpatient proceeds (IPP) in Euros (€). Correlation was assessed between iHISS and TOA, TNO, and TIS. Finally, these patients were reexamined in a follow-up inquiry and the life quality was assessed with the five-level version of the EuroQol five-dimensional (EQ-5D) descriptive system (EQ-5D-5L).Results:We analyzed 12 patients with an average age of 44 years (min. 24 years, max. 75 years). Patients receiving reconstructive surgery experienced median (n{rm{tilde x}}n) TPT of 175 days [interquartile range (IQR), 51–499], TOA of 13 h (IQR, 6–37), TO of 9 h (IQR, 4–25), and TNO of 5 (IQR, 3–11). Further, the patients’ median TIS was 22 days (IQR, 9–86), TNPI was 4 (IQR, 2–8), and iHISS was 77 (IQR, 44–162). The median IPP was 14.595 € (IQR, 5.541–33.709 €). IHISS was positively correlated with Pearson’s r for TIS (0.817), TOA (0.857), and TNO (0.871). The EQ-5D-5L index value resulted in a high level of life quality with a median of 0.898 (min. 0.8, max. 1).Conclusion:Severe hand injuries are related to high efforts for surgical and functional reconstructions, which result in high quality of life measured with the EQ-5D-5L assessment. However, for a defined collective of patients, myoelectric prosthetic functional replacement should be considered. Further studies are necessary to examine functional outcomes and quality of life after bionic prosthetic replacement. Also, a bionic reconstruction score to define hard criteria for taking an acute treatment decision is necessary.

Assessment of frequency of cranial nerve lesions after carotid artery surgery

The aim — to improve the methods of treatment of carotid pathology by analyzing the frequency of the cranial nerves’ lesions through generalization of the literary sources and the results of own observations.Materials and methods. A review of the latest world‑wide‑scale studies (NYCAS, ECST, NASCET, CREST, VSGNE) and analysis of statistical data, dedicated the problem of cranial nerves’ lesions after surgical interventions on the carotid arteries, was conducted. The frequency of cranial nerves’ lesions was retrospectively analyzed in the total number of operations on brachiocephalic arteries at vascular surgery department of Lviv Regional Clinical Hospital for the period from 2008 — 2017 years (1373 operations). The presence of stable or transient cranial nerves’ lesions in the early and late postoperative period was documented by the neuropathologist and the otolaryngologist.Results and discussion. According to world statistical studies, the frequency of cranial nerves’ lesions after surgical interventions on the carotid arteries is 3 — 27 %, according to the European Association of Vascular Surgeons — 5.1 %. The results of American studies are closed to this value: NYCAS — 5.5 %, NASCET — 8.6 % and CREST — 4.7 %. The most frequently injured are: n. hypoglossus, n. glossopharyngeus and n. auricularis magnus. At vascular surgery department of Lviv Regional Clinical Hospital, the frequency of cranial nerves’ lesions after surgical interventions on the carotid arteries was 7.2 %. The most frequent were injuries of n. vagus, n. hypoglossus and n. glossopharyngeus. Clinical symptoms of injury largely regressed during 1 year. In the cases of atherosclerotic lesions of carotid arteries, the higher rates of postoperative neurological symptoms were observed among symptomatic patients in comparison with asymptomatic ones.Conclusions. The frequency of cranial nerves’ lesions according to the data of literary sources is within the range of 3—27 %. N. vagus, n. hypoglossus, and n. glossopharyngeus have highest rate of frequency of the lesion after surgical intervention on the carotid arteries. The injury process is largely reversible within one year after surgery.

Amniotic Constriction Bands: Secondary Deformities and Their Treatments.

The purpose of this study was to report the surgical treatment experience of patients with amniotic constriction bands (ACB) over a 35-year interval and detail consequential limb deformities with emphasis on hands and upper extremities, along with the nature and frequency of their surgical treatment methods. Fifty-one patients were identified; 26 were males and 25 females. The total number of deformities was listed. The total number of operations, individual procedures, and operations plus procedures that were done for each patient and their frequency were recorded. The total number of operations was 117, and total number of procedures was 341. More procedures were performed on the upper extremity (85%) than the lower extremity (15%). Including the primary deformity ACB, 16 different hand deformities secondary to ACB were encountered. Sixteen different surgical methods for the upper extremity were utilized; a primary procedure for ACB and secondary reconstructions for all secondary deformities. Average age at the time of the first procedure was 9.3 months. The most common procedures performed, in order of frequency, were excision of ACB plus Z-plasty, release of partial syndactyly, release of fenestrated syndactyly, full-thickness skin grafts, resection of digital bony overgrowth from amputation stumps, and deepening of first and other digital web spaces. Many hand and upper extremity deformities secondary to ACB are encountered. Children with ACB may require more than one operation including multiple procedures. Numerous surgical methods of reconstruction for these children's secondary deformities are necessary in addition to the customary primary procedure of excision of ACB and Z-plasty.

A branch-and-price algorithm for the Aperiodic Multi-Period Service Scheduling Problem

This paper considers the multi-period service scheduling problem with an aperiodic service policy. In this problem, a set of customers who periodically require service over a finite time horizon is given. To satisfy the service demands, a set of operators is given, each with a fixed capacity in terms of the number of customers that can be served per period. With an aperiodic policy, customers may be served before the period were the service would be due. Two criteria are jointly considered in this problem: the total number of operators, and the total number of ahead-of-time periods. The task is to determine the service periods for each customer in such a way that the service requests of the customers are fulfilled and both criteria are minimized. A new integer programming formulation is proposed, which outperforms an existing formulation. Since the computational effort required to obtain solutions considerably increases with the size of the instances, we also present a reformulation suitable for column generation, which is then integrated within a branch-and-price algorithm. Computational experiments highlight the efficiency of this algorithm for the larger instances.

The Quality of Postoperative Pain Therapy in German Hospitals.

Many patients in German hospitals complain of inadequate treatment of their postoperative pain. Hospital-related structural and procedural variables may affect pain perception and patient satisfaction. We studied the association of individual variables with outcome quality. Data from the years 2011 to 2014 from the world's largest acute pain registry (QUIPS) were evaluated. The analysis was performed with mixed linear regression models. We studied registry data from 138 German hospitals concerning four commonly performed types of operations (total number of operations, 21 114) and found that the intensity of pain, functional impairment, and satisfaction with postoperative pain therapy were all highly variable from one hospital to another. Patients in university hospitals complained more often than those in standard care facilities of highly intense pain (odds ratio [OR] 2.44; 95% con - fidence interval [CI] [1.18; 5.04]) and dissatisfaction (OR 3.58 [1.85; 6.93]). In specialized centers as well, pain intensity (OR 1.39 [1.06; 1.83]) and dissatisfaction (OR 1.59 [1.25; 2.02]) were higher. Pain-related limitation of movement was also reported more commonly in university hospitals (OR 2.12 [0.87; 5.16]) and specialized centers (OR 1.87 [1.33; 2.65]) than in standard care facilities. Less pain-related limitation of movement and higher satisfaction were reported in hospitals in which pain was documented in the patients' charts and the patients felt adequately informed about the treatment options. The current state of postoperative pain therapy leaves much room for improvement. Quality indicators in the field of acute pain medicine might help improve patient care.

A modified exhaustive search on a password system using SHA-1

In this paper, we show a method of exhaustive search on a password system that uses SHA-1 iteratively. Our method uses both the technique shown in Steube [16] and a technique for computing repetitions of SHA-1. Combining these two techniques reduces the total number of operations. We also show how to apply our method to MS Office (Microsoft Office) 2007/2010.

Scheduling policies for multi-period services

This paper discusses a multi-period service scheduling problem. In this problem, a set of customers is given who periodically require service over a finite time horizon. To satisfy the service demands, a set of operators is given, each with a fixed capacity in terms of the number of customers an operator can serve per period. The task is to determine for each customer the periods in which he will be visited by an operator such that the periodic service requests of the customers are adhered to and the total number of operators used over the time horizon is minimal. Two alternative policies for scheduling customer visits are considered. In the first one, a customer is visited just on time, i.e., in the period where he or she has a demand for service. The second policy allows service visits ahead of time. The rationale behind this policy is that allowing irregular visits may reduce the overall number of operators needed throughout the time horizon. To solve the problem, integer linear programming formulations are proposed for both policies and numerical experiments are presented that show the reduction in the number of operators used when visits ahead of time are allowed. As only small instances can be solved optimally, a heuristic algorithm is introduced in order to obtain good quality solutions and shorter computing times.

Integral Images: Efficient Algorithms for Their Computation and Storage in Resource-Constrained Embedded Vision Systems.

The integral image, an intermediate image representation, has found extensive use in multi-scale local feature detection algorithms, such as Speeded-Up Robust Features (SURF), allowing fast computation of rectangular features at constant speed, independent of filter size. For resource-constrained real-time embedded vision systems, computation and storage of integral image presents several design challenges due to strict timing and hardware limitations. Although calculation of the integral image only consists of simple addition operations, the total number of operations is large owing to the generally large size of image data. Recursive equations allow substantial decrease in the number of operations but require calculation in a serial fashion. This paper presents two new hardware algorithms that are based on the decomposition of these recursive equations, allowing calculation of up to four integral image values in a row-parallel way without significantly increasing the number of operations. An efficient design strategy is also proposed for a parallel integral image computation unit to reduce the size of the required internal memory (nearly 35% for common HD video). Addressing the storage problem of integral image in embedded vision systems, the paper presents two algorithms which allow substantial decrease (at least 44.44%) in the memory requirements. Finally, the paper provides a case study that highlights the utility of the proposed architectures in embedded vision systems.

The Struggle for Equity: An Examination of Surgical Services at Two NGO Hospitals in Rural Haiti.

Health systems must deliver care equitably in order to serve the poor. Both L'Hôpital Albert Schweitzer (HAS) and L'Hôpital Bon Sauveur (HBS) have longstanding commitments to provide equitable surgical care in rural Haiti. HAS charges fees that demonstrate a preference for the rural population near the hospital, with free care available for the poorest. HBS does not charge fees. The two hospitals are otherwise similar in surgical capacity and rural location. We retrospectively reviewed operative case-logs at both hospitals from June 1 to Aug 31, 2012. The records were compared by total number of operations, geographic distribution of patients and number of elective operations. Using geography as a proxy for poverty, we analyzed the equity achieved under the financial systems at both hospitals. Patients from the rural service area received 86% of operations at HAS compared to 38% at HBS (p < 0.001). Only 5% of all operations at HAS were performed on patients from outside the service area for elective conditions compared to 47% at HBS (p < 0.001). Within its rural service area, HAS performed fewer operations on patients from the most destitute areas compared to other locations (40.3 vs. 101.3 operations/100,000 population, p < 0.001). Using fees as part of an equity strategy will likely disadvantage the poorest patients, while providing care without fees may encourage patients to travel from urban areas that contain other hospitals. Health systems striving to serve the poor should continually evaluate and seek to improve equity, even within systems that provide free care.

Faster quantum searching with almost any diffusion operator

Grover search algorithm drives a quantum system from an initial state to a desired final state by using selective phase inversions of these two states. In (1), we studied a generalization of Grover algorithm which relaxes the assumption of the efficient implementation of the selective phase inversion of the initial state, also known as diffusion operator. This assumption is known to become a serious handicap in cases of physical interest (2,3,4,5). Our general search algorithm works with almost arbitrary diffusion operator with only restriction of having the initial state as one of its eigenstates. The price that we pay for using arbitrary operator is an increase in the number of oracle queries by a factor of order of B, where B is a characteristic of the eigenspectrum of diffusion operator and it can be large in some situations. Here we show that by using quantum fourier transform, we can regain the optimal query complexity of Grover algorithm without losing the freedom of using arbitrary diffusion operators for quantum searching. However, the total number of operators required by algorithm is still order of B times more than that of Grover algorithm. So our algorithm offers advantage only if oracle operator is computationally more expensive than diffusion operator, which is true in most search problems.

The struggle for equity: an examination of surgical services at two NGO hospitals in rural Haiti

BackgroundHealth systems must deliver care equitably to serve the poor. Both L'Hôpital Albert Schweitzer (HAS) and L'Hôpital Bon Sauveur (HBS) have longstanding commitments to provide equitable surgical care in rural Haiti. HAS charges fees that reflect a preference for the rural population near the hospital, with free care available for the poorest. HBS does not charge fees. The two hospitals are otherwise similar in surgical capacity and rural location. Using geography as a proxy for poverty, we analysed the equity achieved under the financial system at both hospitals. MethodsWe retrospectively reviewed operative case-logs for general surgery and orthopaedic cases at both hospitals from June 1, to Aug 31, 2012. The records were compared by total number of operations, geographic distribution of patients, and number of elective operations. The service areas were defined as the governmental administrative units closest to both hospitals. For HAS, we analysed the number of operations performed on patients from the most poor and least poor regions within the service area; similarly detailed geographic information was not available from HBS. Rates were compared with χ2 tests. The Ethics Committees at both hospitals and the Institutional Review Board at Partners Healthcare approved the study. FindingsPatients from the rural service area received 306 operations (86·2%) at HAS compared with 149 (38·1%) at HBS (p<0·0001). Only 16 operations (4·5%) at HAS were performed on patients from outside the service area for elective conditions compared with 179 (47·0%) at HBS (p<0·0001). Within its rural service area, HAS performed fewer operations on patients from the most destitute areas compared with other locations (4·0 operations per 10 000 population vs 10·1 operations per 10 000 population; p<0·0001). InterpretationUse of fees as part of an equity strategy will likely disadvantage the poorest patients, while providing care without fees might encourage patients to travel from urban areas that contain other hospitals. Health systems striving to serve the poor should continually evaluate and seek to improve equity, even within systems that provide free care. FundingNone.

Bariatric surgery in Russia in 2011-2013

Within three years (2011 - 2013), we collected data on the operations carried out by sending a questionnaire to members of the Russian Society of Bariatric Surgeons. In the questionnaire were asked to fill in a table on the total number of operations, their structure, subject to the applicable access and report on fatal cases indicating the cause of death.The number of executed operations (excluding installation gastric balloon) increased from 989 to 1525.In 2012, steel longitudinal gastrectomy performed more often than banding. The share gastroshuntirovany continues to decline throughout the period.In 2013, against the backdrop of a significant increase in the number of bariatric interventions deaths were recorded.

Sigma decomposition

In composite Higgs models the Higgs is a pseudo-Goldstone boson of a high-energy strong dynamics. We have constructed the effective chiral Lagrangian for a generic symmetric coset, restricting to CP-even bosonic operators up to four momenta which turn out to depend on seven parameters, aside from kinetic terms. Once the same sources of custodial symmetry breaking as in the Standard Model are considered, the total number of operators in the basis increases up to ten, again aside from kinetic terms. Under these assumptions, we have then particularised the discussion to three distinct frameworks: the original $SU(5)/SO(5)$ Georgi-Kaplan model, the minimal custodial-preserving $SO(5)/SO(4)$ model and the minimal $SU(3)/(SU(2)\times U(1))$ model, which intrinsically breaks custodial symmetry. The projection of the high-energy electroweak effective theory into the bosonic sector of the Standard Model is shown to match the low-energy chiral effective Lagrangian for a dynamical Higgs, and it uncovers strong relations between the operator coefficients. Finally, the relation with the bosonic basis of operators describing linear realisations of electroweak symmetry breaking is clarified.

Fast Fourier transform using matrix decomposition

To reduce both the multiplicative complexity and total number of operations, this paper introduces a modeling scheme of the fast Fourier transform (FFT) to decompose the discrete Fourier transform (DFT) matrix recursively into a set of sparse matrices. Integrating three orthogonal transforms, the Hadamard, Modified Haar and Hybrid transforms, the proposed scheme is able to obtain different FFT representations with less computation operations than state of the arts. To investigate the applications of the proposed FFT scheme, a multi-stage image encryption algorithm is also introduced. Experimental results and security analysis are provided to show its encryption performance.

Trends and outcomes of valve surgery: 16-year results of Netherlands Cardiac Surgery National Database†

The aim was to describe procedural volumes, patient risk profile and outcomes of heart valve surgery in the past 16 years in Netherlands. The Dutch National Database for Cardio-Thoracic Surgery includes approximately 200 000 cardiac operations performed between 1995 and 2010. Information on all valve surgeries (56 397 operations) was extracted. We determined trends for changes in procedural volume, demographics, risk profile and in-hospital mortality of valve operations. Because of incomplete data in the first years of registration, the total number of operations in those years was estimated using Poisson regression. For a subset from 2007 to 2010, follow-up data were available. Survival status was obtained through linkage with the national Cause of Death Registry, and survival analysis was performed using Kaplan-Meier method. Information on discharge and readmissions was obtained from the National Hospital Discharge Registry. The annual volume of heart valve operations increased by more than 100% from an estimated 2431 in 1995 to 5906 in 2010. Adjusted for population size in Netherlands, the number of operations per 100 000 adults increased from 20 in 1995 to 43 in 2010. In 2010, frequently performed valve surgery included the following: 34.6% isolated aortic valve (AoV) replacement, 21.8% AoV replacement and coronary artery bypass grafting (CABG), 14.6% isolated mitral valve surgery (repair or replacement) and 9.1% mitral valve and CABG. In AoV surgery, an increasing use of bioprostheses in all age categories is observed. In mitral valve surgery, 75.4% was performed by repair rather than replacement in 2010. In-hospital mortality for all valve surgery decreased significantly from 4.6% in 2007 to 3.6% in 2010, whereas the mean logistic EuroSCORE remained stable (median 5.8, P = 1.000). Thirty-day mortality after all valve surgery was 3.9% and 120-day mortality was 6.5%. At 1 year, survival after all valve surgery was 91.6% and a reoperation had been performed in 1.6%. The median postoperative length of stay was 7 days (interquartile range (IQR) 5-11) in the primary hospital and 11 days (IQR 8-16), including subsequent stay, in the secondary hospital. The results of this study provide a comprehensive overview of valve surgery trends and outcomes in Netherlands. The number of heart valve operations performed in Netherlands has increased since 1995. The significant decrease in mortality and unchanged EuroSCORE between 2007 and 2010 might reflect a general improvement of the safety of valve surgery.

Gunshot wounds and blast injuries to the face are associated with significant morbidity and mortality

Gunshot wounds and blast injuries to the face (GSWBIFs) produce complex wounds requiring management by multiple surgical specialties. Previous work is limited to single institution reports with little information on processes of care or outcome. We sought to determine those factors associated with hospital complications and mortality. We performed an 11-year multicenter retrospective cohort analysis of patients sustaining GSWBIF. The face, defined as the area anterior to the external auditory meatuses from the top of the forehead to the chin, was categorized into three zones: I, the chin to the base of the nose; II, the base of the nose to the eyebrows; III, above the brows. We analyzed the effect of multiple factors on outcome. From January 1, 2000, to December 31, 2010, we treated 720 patients with GSWBIF (539 males, 75%), with a median age of 29 years. The wounding agent was handgun in 41%, explosive (shotgun and blast) in 20%, rifle in 6%, and unknown in 33%. Prehospital or resuscitative phase airway was required in 236 patients (33%). Definitive care was rendered by multiple specialties in 271 patients (38%). Overall, 185 patients died (26%), 146 (79%) within 48 hours. Of the 481 patients hospitalized greater than 48 hours, 184 had at least one complication (38%). Factors significantly associated with any of a total of 207 complications were total number of operations (p < 0.001), Revised Trauma Score (RTS, p < 0.001), and head Abbreviated Injury Scale (AIS) score (p < 0.05). Factors significantly associated with mortality were RTS (p < 0.001), head AIS score (p < 0.001), total number of operations (p < 0.001), and age (p < 0.05). An injury located in Zone III was independently associated with mortality (p < 0.001). GSWBIFs have high mortality and are associated with significant morbidity. The multispecialty involvement required for definitive care necessitates triage to a trauma center and underscores the need for an organized approach and the development of effective guidelines. Therapeutic/care management, level III.

Challenges in the diagnosis and treatment of transsexualism in contemporary China.

Challenges in the diagnosis and treatment of transsexualism in contemporary China.

Patient flow and medical consequences of the Israeli operation Pillar of Defence: a retrospective study

Background The Israeli military attack Pillar of Defence on the Gaza Strip, occupied Palestinian territory (also referred to as State of Palestine), from Nov 14–21, 2012, killed more than 190 and injured more than 1490 Palestinians. 48 of the people killed were aged 18 years or younger, and 16 were 5 years or younger. 504 of the people injured were aged 18 years or younger, and 195 were 5 years or younger. The rest of the individuals injured or killed were older than 18 years. Six Israelis were killed and 224 were injured. We were working in Al-Shifa Hospital, Gaza City, during the attacks and assessed the flow of patients through the emergency department during 8 days of bombing by the Israeli military. Methods Data for all patients brought to Al-Shifa Hospital's emergency department were obtained retrospectively from handwritten emergency department protocols, and intensive care unit (ICU) and operating room records. We recorded the total number of hospital admissions, deaths, admissions to the ICU, patients operated on, and patients transferred to Egypt. Data were gathered for admissions, demographics, cause of injury, surgery, ICU admissions, and deaths. Microsoft Excel 2010 was used to analyse the data. The study was approved by the hospital's director and board. Findings 680 of the injured or killed Palestinians were brought to the hospital's emergency department with injuries from bombing by drones, F-16 fighter planes, helicopters, or naval artillery: 501 (74%) male and 179 (26%) female individuals, including 74 (11%) children aged 18 years or younger. 145 (21%) Palestinians were admitted: 44 (30%) during the first 4 days and 101 (70%) during the last 4 days of bombing. 43 (30%) of 145 individuals needed intensive care (32 [74%] adults and 11 [26%] aged ≤5 years). Of the patients admitted to the ICU, 29 (67%) were discharged, 11 (26%) transferred to Egypt, and three (7%) died in the ICU. 62 (9%) of 680 people who were injured died: 50 (81%) were dead on arrival, seven (11%) died in the operating room, three (5%) died in the ICU, and two (3%) after transfer to Egypt. 110 (76%) of 145 patients admitted to Al-Shifa Hospital were operated on, most were taken directly to the operating room after rapid triage and critical stabilisation in the emergency department. 39 (35%) patients had laparotomies, and 42 (38%) orthopaedic, 22 (20%) neurosurgical, eight (7%) vascular, and four (4%) plastic surgical operations; total number of operations was greater than 110 because most patients had more than one trauma. 39 patients were transferred to Egypt. Most of the people with injuries were civilians. Interpretation A large influx of patients who had war trauma was managed in Al-Shifa Hospital despite the erosion of infrastructure, supplies, and general population health from the previous 5-year Israeli siege. Improved, stricter triage reduced patient admission during the 2012 Israeli military attack versus the Israeli military attacks in 2008–09. Additionally, hospital staff were better prepared and trained for the casualties of the 2012 military attack and few deaths occurred in the ICU. A high number of individuals with fatal injuries were dead on arrival, indicating the need for better prehospital triage to safeguard hospital capacity. Funding None.

분산전원을 포함한 배전계통에서 설치비용과 유지보수 비용을 고려한 병렬 캐패시터-리액터 Bank의 최적 설치 위치 선정

This paper proposes the allocation method for capacitor-reactor banks in a distribution system with dispersed generators to reduce the installation costs, the maintenance costs and minimize the loss of electrical energy. The expected lifetime and maintenance period of devices with moving parts depends on the total number of operations, which affects the replacement and maintenance period for aging equipment under a limited budget. In this paper, the expected device lifetimes and the maintenance period are included in the formulation, and the optimal operation status of the devices is determined using a genetic algorithm. The optimal numbers and locations for capacitor-reactor banks are determined based on the optimal operation status. Simulation results in a 69-bus distribution system with the dispersed generator show that the proposed technique performs better than conventional methods.

Mortality and Re-Operation Rate after Proximal Femoral Fracture Surgery by Trainees

To review records of 761 patients who underwent surgery for proximal femoral fractures to determine whether surgeon's experience and volume was associated with 6-month mortality and reoperation rates. Records of 761 patients who underwent surgery for proximal femoral fractures were reviewed. Patients operated on by a consultant or trainees with supervision of a scrubbed consultant were classified as the consultant group (n=214). Patients operated on by trainees alone (n=516) or trainees with supervision of an unscrubbed consultant (n=31) were classified as the trainee group (n=547). A total of 21 trainees were identified. They had different levels of experience, which was quantified according to the total number of operations performed for proximal femoral fractures from the start of their training to the start of the study. Patients in the trainee group were older (80 ± 12 vs. 77 ± 14 years, p<0.001), and the fractures were more complex in the consultant group. The 6-month mortality rate was 24.2% (n=184). The odds of dying within 6 months after operation was 80% higher in patients operated on by trainees without supervision of a scrubbed consultant (odds ratio, 1.8; 95% confidence interval, 1.1-2.7). Variables associated with the 6-month mortality rate were age (p<0.001), American Society of Anesthesiologists grade (p<0.001), pre-injury activity level (p<0.001), and the surgeon's grade (p<0.05). The 6-month reoperation rate was 3.8% (n=29) and did not differ significantly in the 2 groups. The experience level of the trainees was not associated with the 6-month reoperation rate. The odds of dying within 6 months after a surgery for proximal femoral fractures was 80% higher in patients operated on by trainees without supervision of a scrubbed consultant.