Are Patient Outcomes Affected by the Presence of a Fellow or Resident in Lumbar Decompression Surgery?
| العنوان: | Are Patient Outcomes Affected by the Presence of a Fellow or Resident in Lumbar Decompression Surgery? |
|---|---|
| المؤلفون: | Dhruv K.C. Goyal, Alan S. Hilibrand, Matthew S. Galetta, Barrett I. Woods, David Greg Anderson, Ryan Guzek, Srikanth N. Divi, Kristen E. Radcliff, Ian D. Kaye, Mark F. Kurd, Alexander R. Vaccaro, Jeffrey A. Rihn, Gregory D. Schroeder, Christopher K. Kepler |
| المصدر: | Spine. 46:35-40 |
| بيانات النشر: | Ovid Technologies (Wolters Kluwer Health), 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | 030222 orthopedics, medicine.medical_specialty, Univariate analysis, business.industry, Visual analogue scale, Decompression, Retrospective cohort study, Oswestry Disability Index, 03 medical and health sciences, 0302 clinical medicine, Orthopedic surgery, Operative report, Physical therapy, Medicine, Orthopedics and Sports Medicine, Patient-reported outcome, Neurology (clinical), business, 030217 neurology & neurosurgery |
| الوصف: | Study design Retrospective cohort study. Objective The aim of this study was to determine whether the presence of a fellow or resident (F/R) compared to a physician assistant (PA) affected surgical variables or short-term patient outcomes. Summary of background data Although orthopedic spine fellows and residents must participate in minimum number of decompression surgeries to gain competency, the impact of trainee presence on patient outcomes has not been assessed. Methods One hundred and seventy-one patients that underwent a one- to three-level lumbar spine decompression procedure at a high-volume academic center were retrospectively identified. Operative reports from all cases were examined and patients were placed into one of two groups based on whether the first assist was a F/R or a PA. Univariate analysis was used to compare differences in total surgery duration, 30-day and 90-day readmissions, infection and revision rates, patient-reported outcome measures (Short Form-12 Physical Component Score and Mental Component Score, Oswestry Disability Index, Visual Analog Scale [VAS] Back, VAS Leg) between groups. Multiple linear regression was used to assess change in each patient reported outcome and multiple binary logistic regression was used to determine significant predictors of revision, infection, and 30- or 90-day readmission. Results Seventy-eight patients were included in the F/R group compared to 93 patients in the PA group. There were no differences between groups for total surgery time, 30-day or 90-day readmissions, infection, or revision rates. Using univariate analysis, there were no differences between the two groups pre- or postoperatively (P > 0.05). Using multivariate analysis, presence of a surgical trainee did not significantly influence any patient reported outcome and did not affect infection, revision, or 30- and 90-day readmission rates. Conclusion This is one of the first studies to show that the presence of an orthopedic spine fellow or resident does not affect patient short-term outcomes in lumbar decompression surgery. Level of evidence 3. |
| تدمد: | 1528-1159 0362-2436 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::073c82c5d27606e9084269bade4c1ac2 https://doi.org/10.1097/brs.0000000000003721 |
| رقم الأكسشن: | edsair.doi...........073c82c5d27606e9084269bade4c1ac2 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15281159 03622436 |
|---|