دورية أكاديمية
Association between anaesthesia-surgery team sex diversity and major morbidity.
| العنوان: | Association between anaesthesia-surgery team sex diversity and major morbidity. |
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| المؤلفون: | Hallet J; Department of Surgery, University of Toronto, Toronto, Ontario, Canada.; Division of Surgical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.; Clinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada.; Cancer Program, ICES, Toronto, Ontario, Canada., Sutradhar R; Cancer Program, ICES, Toronto, Ontario, Canada.; Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Ontario, Canada., Flexman A; Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada.; Department of Anesthesiology, St Paul's Hospital/Providence Health Care, Vancouver, British Columbia, Canada., McIsaac DI; Departments of Anesthesiology and Pain Medicine, University of Ottawa and Ottawa Hospital, Ottawa, Ontario, Canada., Carrier FM; Carrefour de l'innovation et santé des populations, Centre de recherche du CHUM, and Department of Anesthesiology and Division of Critical Care, Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada.; Department of Anesthesiology and Pain Medicine, Université de Montréal, Montréal, Québec, Canada., Turgeon AF; Department of Anesthesiology and Critical Care Medicine, Division of Critical Care Medicine, Université Laval, Québec City, Québec, Canada.; Population Health and Optimal Health Practices Research Unit, Trauma-Emergency-Critical Care Medicine, CHU de Québec-Université Laval Research Centre, Université Laval, Québec City, Québec, Canada., McCartney C; Department of Anesthesiology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.; Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada., Chan WC; Cancer Program, ICES, Toronto, Ontario, Canada., Coburn N; Department of Surgery, University of Toronto, Toronto, Ontario, Canada.; Division of Surgical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.; Clinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada.; Cancer Program, ICES, Toronto, Ontario, Canada., Eskander A; Division of Surgical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.; Clinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada.; Cancer Program, ICES, Toronto, Ontario, Canada.; Department of Otolaryngology Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada., Jerath A; Clinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada.; Cancer Program, ICES, Toronto, Ontario, Canada.; Department of Anesthesiology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.; Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada., Perez d'Empaire P; Department of Anesthesiology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.; Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada., Lorello G; Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada.; Department of Anesthesiology and Wilson Centre, University Health Network, Toronto, Ontario, Canada.; Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada. |
| المصدر: | The British journal of surgery [Br J Surg] 2024 May 03; Vol. 111 (5). |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Oxford University Press on behalf of BJS Foundation Ltd Country of Publication: England NLM ID: 0372553 Publication Model: Print Cited Medium: Internet ISSN: 1365-2168 (Electronic) Linking ISSN: 00071323 NLM ISO Abbreviation: Br J Surg Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2021- : [Oxford] : Oxford University Press on behalf of BJS Foundation Ltd. Original Publication: [Bristol, England : Baltimore : John Wright & Sons ; Williams & Wilkins Co. |
| مواضيع طبية MeSH: | Postoperative Complications*/epidemiology , Postoperative Complications*/etiology , Patient Care Team*, Humans ; Female ; Retrospective Studies ; Male ; Middle Aged ; Aged ; Adult ; Surgeons/statistics & numerical data ; Surgical Procedures, Operative/statistics & numerical data ; Physicians, Women/statistics & numerical data |
| مستخلص: | Background: Team diversity is recognized not only as an equity issue but also a catalyst for improved performance through diversity in knowledge and practices. However, team diversity data in healthcare are limited and it is not known whether it may affect outcomes in surgery. This study examined the association between anaesthesia-surgery team sex diversity and postoperative outcomes. Methods: This was a population-based retrospective cohort study of adults undergoing major inpatient procedures between 2009 and 2019. The exposure was the hospital percentage of female anaesthetists and surgeons in the year of surgery. The outcome was 90-day major morbidity. Restricted cubic splines were used to identify a clinically meaningful dichotomization of team sex diversity, with over 35% female anaesthetists and surgeons representing higher diversity. The association with outcomes was examined using multivariable logistic regression. Results: Of 709 899 index operations performed at 88 hospitals, 90-day major morbidity occurred in 14.4%. The median proportion of female anaesthetists and surgeons was 28 (interquartile range 25-31)% per hospital per year. Care in hospitals with higher sex diversity (over 35% female) was associated with reduced odds of 90-day major morbidity (OR 0.97, 95% c.i. 0.95 to 0.99; P = 0.02) after adjustment. The magnitude of this association was greater for patients treated by female anaesthetists (OR 0.92, 0.88 to 0.97; P = 0.002) and female surgeons (OR 0.83, 0.76 to 0.90; P < 0.001). Conclusion: Care in hospitals with greater anaesthesia-surgery team sex diversity was associated with better postoperative outcomes. Care in a hospital reaching a critical mass with over 35% female anaesthetists and surgeons, representing higher team sex-diversity, was associated with a 3% lower odds of 90-day major morbidity. (© The Author(s) 2024. Published by Oxford University Press on behalf of BJS Foundation Ltd.) |
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| معلومات مُعتمدة: | Sunnybrook Alternate Funding Plan Innovation Fund |
| تواريخ الأحداث: | Date Created: 20240515 Date Completed: 20240515 Latest Revision: 20240518 |
| رمز التحديث: | 20240518 |
| مُعرف محوري في PubMed: | PMC11094651 |
| DOI: | 10.1093/bjs/znae097 |
| PMID: | 38747328 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1365-2168 |
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| DOI: | 10.1093/bjs/znae097 |