Journal article
The Effect of Time During the Academic Year or Resident Training Level on Complication Rates After Lower-Extremity Orthopaedic Trauma Procedures
Journal of bone and joint surgery. American volume, Vol.100(22), pp.1919-1925
11/21/2018
DOI: 10.2106/JBJS.18.00279
PMID: 30480596
Abstract
Few studies have evaluated the effect of resident participation on morbidity and mortality after orthopaedic trauma surgery. The goal of this study was to evaluate whether complications after orthopaedic trauma procedures involving residents correlate with the level of resident training and the timing in the academic year.
The American College of Surgeons National Surgical Quality Improvement Program database was queried for all patients who underwent operative fixation of proximal femoral fractures, femoral shaft fractures, and tibial shaft fractures from 2005 to 2012. A total of 1,851 cases with resident involvement were identified, and complication rates were calculated and analyzed with respect to resident level of training (postgraduate year [PGY] 1 through 6) and the academic quarter in which the procedure took place.
The composite complication rates in the first academic quarter for serious adverse events (10.96%), any adverse events (18.57%), and surgical complications (9.62%) did not significantly differ from those during the remainder of the year (11.40%, 17.81%, and 7.19%, respectively). The rates of any adverse event were significantly higher for senior-level residents (quarter 1, 20.58%; quarter 2, 20.05%) than for junior residents (quarter 1, 11.76%; quarter 2, 12.44%) during the first half of the academic year (quarter 1, p = 0.044; quarter 2, p = 0.024).
This evaluation of the composite complication rates found no "July effect" in lower-extremity orthopaedic trauma surgery. There was evidence for a July effect for superficial surgical site infections, in that there was a significantly higher rate in the first academic quarter. Senior residents may benefit from more oversight or instruction during the first portion of the academic year.
Details
- Title: Subtitle
- The Effect of Time During the Academic Year or Resident Training Level on Complication Rates After Lower-Extremity Orthopaedic Trauma Procedures
- Creators
- Aaron J Casp - Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VirginiaBrendan M Patterson - Department of Orthopaedic Surgery, University of Iowa, Iowa City, IowaSeth R Yarboro - Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VirginiaJosh N Tennant - Department of Orthopaedics, University of North Carolina, Chapel Hill, North Carolina
- Resource Type
- Journal article
- Publication Details
- Journal of bone and joint surgery. American volume, Vol.100(22), pp.1919-1925
- DOI
- 10.2106/JBJS.18.00279
- PMID
- 30480596
- NLM abbreviation
- J Bone Joint Surg Am
- ISSN
- 0021-9355
- eISSN
- 1535-1386
- Publisher
- Journal of Bone and Joint Surgery Incorporated; United States
- Language
- English
- Date published
- 11/21/2018
- Academic Unit
- Orthopedics and Rehabilitation
- Record Identifier
- 9984040356002771
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