Title :

Influence of Daily Variations in Individual Surgeon's Operative Time on Patient Outcomes

Author(s) :

Meunier, Etienne [Auteur]
Hospices Civils de Lyon [HCL]
Payet, Cécile [Auteur]
Health Service and Performance Research [HESPER]
Hospices Civils de Lyon [HCL]
Peix, Jean-Louis [Auteur]
Hospices Civils de Lyon [HCL]
Kraimps, Jean-Louis [Auteur]
Service de chirurgie générale et endocrinienne [CHU de Poitiers]
Menegaux, Fabrice [Auteur]
CHU Pitié-Salpêtrière [AP-HP]
Pattou, Francois [Auteur]
Recherche translationnelle sur le diabète (RTD) - U1190
Service de chirurgie générale et endocrinienne
Sebag, Frédéric [Auteur]
Hôpital de la Conception [CHU - APHM] [LA CONCEPTION]
Lifante, Jean Christophe [Auteur]
Health Service and Performance Research [HESPER]
Hospices Civils de Lyon [HCL]
Duclos, Antoine [Auteur]
Health Service and Performance Research [HESPER]
Hospices Civils de Lyon [HCL]

Journal title :

World Journal of Surgery

Abbreviated title :

World J Surg

Volume number :

43

Pages :

2720-2727

Publisher :

Springer Verlag

Publication date :

2019-07-16

ISSN :

1432-2323

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Background Evidence is lacking regarding the potential association between daily variation in individual surgeon's operative time, procedure after procedure, and risk of patient complication. We assumed that surgeon ...
Show more >Background Evidence is lacking regarding the potential association between daily variation in individual surgeon's operative time, procedure after procedure, and risk of patient complication. We assumed that surgeon deviation from the expected procedure duration may be harmful for patient. Method All patients who underwent a thyroidectomy undertaken in five hospitals during a 1-year period were included prospectively. For each thyroidectomy, we estimated the expected operative time from a multilevel linear regression considering the attending surgeon who performed the operation, the patient preoperative risk, and the procedure complexity. Three groups of thyroidectomies were identified according to whether the observed duration is: slower than expected, as expected, or faster than expected. Rates of permanent recurrent laryngeal nerve palsy and hypoparathyroidism at 6 months were then compared between these groups. Results A total of 3102 patients who underwent a thyroidectomy undertaken by 22 surgeons were considered. Risk of laryngeal nerve palsy was higher in the “slow” group than in the “normal” group (OR = 4.63, 95% confidence interval 2.21–9.70), as was that of hypoparathyroidism (OR = 2.43, 95% confidence interval 1.21–4.88). There was no significant difference between “fast” and “normal” groups for either complication. Deviation from expected procedure duration was more frequent at the end than at the beginning of the daily operation schedule (29.4% vs. 18.3%, respectively, P < .001). Conclusion Patients had a greater risk of complication when the surgeon performed thyroidectomy slower than expected. Surgeons avoiding excessive deviations from their expected procedures durations reflect safer practice.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
Inserm
CHU Lille

Collections :

• Recherche translationnelle sur le diabète (RTD) - U1190

Submission date :

2024-01-19T23:49:18Z
2024-11-04T14:25:57Z