Predicting the future caretakers of traumatic vascular injury management via operative exposure among surgical trainees

IF 3.9 2区医学 Q1 PERIPHERAL VASCULAR DISEASE Journal of Vascular Surgery Pub Date : 2025-01-01 DOI:10.1016/j.jvs.2024.07.098

Young Kim MD, MS , Nicole A. Heidt MD , Christina L. Cui MD, MAS , Brian F. Gilmore MD , Sunita D. Srivastava MD , Dawn M. Coleman MD

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Abstract

Background

The management of vascular trauma requires specialized training and expertise. Although traumatic vascular injury is treated currently by both vascular and trauma surgeons in modern practice, it remains unclear who will inherit the role of managing vascular trauma in the coming decades. In this study, we examined disparities in operative experience in vascular trauma among surgical trainees across different surgical specialties.

Methods

Accreditation Council for Graduate Medical Education national operative log reports were collected for graduating vascular surgery residents (VSRs), vascular surgery fellows (VSFs), and general surgery residents (GSRs) from 2012 to 2022. Total operative volume for traumatic vascular injury was examined, as were the five major contributing operative domains (neck, thoracic, abdominal, peripheral, and fasciotomy).

Results

A total of 22,052 GSRs, 334 VSRs, and 1672 VSFs graduated over the 10-year study period. VSR had the highest vascular trauma case volume (24.9 ± 3.9 cases/5 years), followed by VSF (22.1 ± 1.5 cases/2 years) then GSR (2.4 ± 0.3 cases/5 years; P < .001). Thoracic vessel exploration/repair (0.7 cases vs 0.6 cases vs 0.0 cases), abdominal vessel exploration/repair (1.0 cases vs 0.9 cases vs 0.0 cases), neck vessel exploration/repair (4.0 cases vs 3.4 cases vs 0.2 cases), peripheral vessel exploration/repair (12.1 cases vs 9.5 cases vs 1.1 cases), and lower extremity fasciotomy for trauma (7.2 cases vs 7.6 cases vs 1.1 cases) were most frequent among the VSR and VSF groups (P < .001 each). On linear regression analysis, both VSF (+0.5 cases/y; R² = 0.81; P < .001) and GSR (+0.1 cases/y; R² = 0.75; P = .001) groups experienced a growth in vascular trauma volume. Contrariwise, vascular trauma volume did not change among graduating VSRs (R² = 0.13; P = .31).

Conclusions

Dedicated vascular surgical training provides the highest operative exposure to civilian vascular trauma in the United States.

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通过外科实习生的手术经验预测创伤性血管损伤处理的未来护理人员。

背景：血管创伤的治疗需要专门的培训和专业知识。虽然目前在现代实践中血管外科医生和创伤外科医生都在治疗创伤性血管损伤，但未来几十年谁将继承管理血管创伤的角色仍不明确。在这项研究中，我们考察了不同外科专业的外科学员在血管创伤手术经验方面的差异：方法：我们收集了 2012 年至 2022 年期间毕业的血管外科住院医师（VSR）、血管外科研究员（VSF）和普外科住院医师（GSR）的国家手术日志报告。对创伤性血管损伤的手术总量以及五大手术领域（颈部、胸部、腹部、外周和筋膜切开术）进行了研究：结果：十年研究期间，共有 22,052 名 GSR、334 名 VSR 和 1,672 名 VSF 毕业。VSR的血管创伤病例数最多（24.9 ± 3.9例/5年），其次是VSF（22.1 ± 1.5例/2年），然后是GSR（2.4 ± 0.3例/5年，p2=0.81，p2=0.75，p=0.001）。相反，在即将毕业的 VSR 中，血管创伤量没有变化（R2=0.13，P=0.31）：结论：在美国，专门的血管外科培训为平民提供了最多的血管创伤手术机会。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Vascular Surgery 医学-外科

CiteScore

7.70

自引率

18.60%

发文量

1469

审稿时长

54 days

期刊介绍： Journal of Vascular Surgery ® aims to be the premier international journal of medical, endovascular and surgical care of vascular diseases. It is dedicated to the science and art of vascular surgery and aims to improve the management of patients with vascular diseases by publishing relevant papers that report important medical advances, test new hypotheses, and address current controversies. To acheive this goal, the Journal will publish original clinical and laboratory studies, and reports and papers that comment on the social, economic, ethical, legal, and political factors, which relate to these aims. As the official publication of The Society for Vascular Surgery, the Journal will publish, after peer review, selected papers presented at the annual meeting of this organization and affiliated vascular societies, as well as original articles from members and non-members.

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