Pub Date : 2024-08-30DOI: 10.1016/j.amjsurg.2024.115935
John L Tarpley, Keir Thelander, Margaret J Tarpley
{"title":"Our surgical practice with the Pan-African Academy of Christian Surgeons (PAACS).","authors":"John L Tarpley, Keir Thelander, Margaret J Tarpley","doi":"10.1016/j.amjsurg.2024.115935","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2024.115935","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142144973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-30DOI: 10.1016/j.amjsurg.2024.115942
Background
Remediation frameworks have centered around perspectives of educators. The aim of this study is to explore the insights proposed by surgical trainees to improve remediation processes.
Methods
This qualitative study used semi-structured interviews with 11 doctors who have experienced formal remediation as a surgical trainee. We used reflexive thematic analysis on transcribed interviews.
Results
Trainees recommended creating environments that safeguarded their well-being. Examples include trainee-led peer support groups and external mentors. Feedback conversations and remediation plans were flagged as needing improvement. Opportunities for forward planning for successful remediation were suggested including learning plans, program evaluation and aligning training program structure with expectations.
Conclusions
These findings about trainees' insights on improving remediation highlighted the need for further emotional support for trainees. Supervisors need further support with feedback conversations and remediation plans. Actively seeking out trainee perspectives and integrating their recommendations when designing remediation processes should improve outcomes.
{"title":"“A clean slate”: Insights for improving remediation from the perspectives of underperforming surgical trainees","authors":"","doi":"10.1016/j.amjsurg.2024.115942","DOIUrl":"10.1016/j.amjsurg.2024.115942","url":null,"abstract":"<div><h3>Background</h3><p>Remediation frameworks have centered around perspectives of educators. The aim of this study is to explore the insights proposed by surgical trainees to improve remediation processes.</p></div><div><h3>Methods</h3><p>This qualitative study used semi-structured interviews with 11 doctors who have experienced formal remediation as a surgical trainee. We used reflexive thematic analysis on transcribed interviews.</p></div><div><h3>Results</h3><p>Trainees recommended creating environments that safeguarded their well-being. Examples include trainee-led peer support groups and external mentors. Feedback conversations and remediation plans were flagged as needing improvement. Opportunities for forward planning for successful remediation were suggested including learning plans, program evaluation and aligning training program structure with expectations.</p></div><div><h3>Conclusions</h3><p>These findings about trainees' insights on improving remediation highlighted the need for further emotional support for trainees. Supervisors need further support with feedback conversations and remediation plans. Actively seeking out trainee perspectives and integrating their recommendations when designing remediation processes should improve outcomes.</p></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S000296102400494X/pdfft?md5=d9358cd8d207ffa51be312fc9c2e8f26&pid=1-s2.0-S000296102400494X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142136066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-28DOI: 10.1016/j.amjsurg.2024.115936
Background
Trauma complications increase the burden of disease and hospitalization costs for patients. More research evidence is needed on how to more effectively prevent these complications and reduce hospitalization costs based on the characteristics of trauma patients. Therefore, this study will systematically analyze the characteristics of trauma complications and their specific impact on hospitalization costs.
Methods
This is a multi-center retrospective study of trauma hospitalizations from 2018 to 2023. Associations between population characteristics, trauma features, and each complication occurrence were investigated using multiple correspondence analysis. Logistic regression analysis assessed factors influencing trauma complications. Additionally, a generalized linear model analyzed the relative increase in hospital costs for each complication.
Results
A total of 48,032 trauma patients were included, with 22.0% experiencing at least one complication. Thrombosis is more prevalent among elderly women (aged ≥65) with pelvic and extremity trauma. In men aged 18–44 years, respiratory insufficiency and post-traumatic anemia primarily occurred in cases of head injuries and multiple injuries. Chest and multiple injuries predispose people aged 45–64 to pneumonia and electrolyte disorders. Body surface injuries are prone to surgical site infections. Complications resulted in an average relative increase in overall hospitalization costs of 1.32-fold, with thrombosis (1.58-fold), respiratory insufficiency (1.11-fold), post-traumatic anemia (0.58-fold), surgical site infection (0.48-fold), pneumonia (0.53-fold), electrolyte disorders (0.47-fold).
Conclusions
This study systematically analyzed the occurrence characteristics of trauma complications and the burden trends of hospitalization costs due to complications, providing a reference for the formulation of trauma classification and management strategies.
{"title":"Systematic analysis of the occurrence characteristics and impact on hospitalization costs of trauma complications","authors":"","doi":"10.1016/j.amjsurg.2024.115936","DOIUrl":"10.1016/j.amjsurg.2024.115936","url":null,"abstract":"<div><h3>Background</h3><p>Trauma complications increase the burden of disease and hospitalization costs for patients. More research evidence is needed on how to more effectively prevent these complications and reduce hospitalization costs based on the characteristics of trauma patients. Therefore, this study will systematically analyze the characteristics of trauma complications and their specific impact on hospitalization costs.</p></div><div><h3>Methods</h3><p>This is a multi-center retrospective study of trauma hospitalizations from 2018 to 2023. Associations between population characteristics, trauma features, and each complication occurrence were investigated using multiple correspondence analysis. Logistic regression analysis assessed factors influencing trauma complications. Additionally, a generalized linear model analyzed the relative increase in hospital costs for each complication.</p></div><div><h3>Results</h3><p>A total of 48,032 trauma patients were included, with 22.0% experiencing at least one complication. Thrombosis is more prevalent among elderly women (aged ≥65) with pelvic and extremity trauma. In men aged 18–44 years, respiratory insufficiency and post-traumatic anemia primarily occurred in cases of head injuries and multiple injuries. Chest and multiple injuries predispose people aged 45–64 to pneumonia and electrolyte disorders. Body surface injuries are prone to surgical site infections. Complications resulted in an average relative increase in overall hospitalization costs of 1.32-fold, with thrombosis (1.58-fold), respiratory insufficiency (1.11-fold), post-traumatic anemia (0.58-fold), surgical site infection (0.48-fold), pneumonia (0.53-fold), electrolyte disorders (0.47-fold).</p></div><div><h3>Conclusions</h3><p>This study systematically analyzed the occurrence characteristics of trauma complications and the burden trends of hospitalization costs due to complications, providing a reference for the formulation of trauma classification and management strategies.</p></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142144976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-28DOI: 10.1016/j.amjsurg.2024.115937
Reed I Ayabe, Oliver S Eng
{"title":"The cost of waiting: Index vs. delayed cholecystectomy for acute cholangitis.","authors":"Reed I Ayabe, Oliver S Eng","doi":"10.1016/j.amjsurg.2024.115937","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2024.115937","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-28DOI: 10.1016/j.amjsurg.2024.115931
Introduction
Previous studies have demonstrated the benefits of tranexamic acid (TXA) administration in combination with packed red blood cell (PRBC) transfusion in trauma patients without increasing the risk of venous thromboembolism (VTE). However, the effect of TXA in combination with whole blood (WB) has not been studied. Injury, abbreviated injury severity scores (ISS and AIS) and the need for blood transfusions are historically associated with VTE. The objective of this study was to determine the relationship between VTE and the combination of TXA administration and transfusion of PRBCs vs. WB.
Methods
Our institutional trauma registry was queried for trauma patients between 2015 and 2022 who received either WB + TXA or PRBC + TXA either prehospital or within 4 h of arrival. Multivariate analysis was utilized to determine independent risk factors for VTE, which were defined as either a deep vein thrombosis (DVT) or a pulmonary embolism (PE). Model covariates included age, mechanism of injury (MOI), ISS, lower extremity AIS, comorbid conditions, and shock index (SI). Additional outcomes analyzed were hospital length of stay (LOS), ICU LOS, and ventilator days.
Results
Three hundred and five patients had complete data and were included in the analysis. Of those, 251 received WB + TXA and 54 received PRBC + TXA. A total of 34 patients were found to have VTE event (11.1 %); 28 (11.2 %) and 6 (11.1 %) from the WB + TXA and PRBC + TXA groups, respectively. An elevated pre-hospital SI was independently associated with increased VTE rate (OR 1.85, 95 % CI 1.07–3.20). WB transfusion, TXA administration, ISS, and MOI did not influence the rate of VTE.
Conclusion
These data demonstrate that the combination of WB + TXA administered to trauma patients has no higher risk of VTE than patients who receive PRBC + TXA, a comparison that has not been studied clinically to date. Despite the pro thrombotic state enhanced by TXA and the decreased dilutional coagulopathy seen in WB resuscitation, there was no increased risk of VTE compared to TXA + PRBC. There is no evidence that TXA combined with whole blood transfusion is associated with an increased risk of VTE. However, higher pre-hospital SI was associated with an elevated rate of VTE. These clinical features provide insight into patients who may be at an increased risk of developing VTE and may benefit from targeted prevention strategies.
{"title":"TXA combined with whole blood transfusion in trauma patients does not increase the risk of VTE but shock index does","authors":"","doi":"10.1016/j.amjsurg.2024.115931","DOIUrl":"10.1016/j.amjsurg.2024.115931","url":null,"abstract":"<div><h3>Introduction</h3><p>Previous studies have demonstrated the benefits of tranexamic acid (TXA) administration in combination with packed red blood cell (PRBC) transfusion in trauma patients without increasing the risk of venous thromboembolism (VTE). However, the effect of TXA in combination with whole blood (WB) has not been studied. Injury, abbreviated injury severity scores (ISS and AIS) and the need for blood transfusions are historically associated with VTE. The objective of this study was to determine the relationship between VTE and the combination of TXA administration and transfusion of PRBCs vs. WB.</p></div><div><h3>Methods</h3><p>Our institutional trauma registry was queried for trauma patients between 2015 and 2022 who received either WB + TXA or PRBC + TXA either prehospital or within 4 h of arrival. Multivariate analysis was utilized to determine independent risk factors for VTE, which were defined as either a deep vein thrombosis (DVT) or a pulmonary embolism (PE). Model covariates included age, mechanism of injury (MOI), ISS, lower extremity AIS, comorbid conditions, and shock index (SI). Additional outcomes analyzed were hospital length of stay (LOS), ICU LOS, and ventilator days.</p></div><div><h3>Results</h3><p>Three hundred and five patients had complete data and were included in the analysis. Of those, 251 received WB + TXA and 54 received PRBC + TXA. A total of 34 patients were found to have VTE event (11.1 %); 28 (11.2 %) and 6 (11.1 %) from the WB + TXA and PRBC + TXA groups, respectively. An elevated pre-hospital SI was independently associated with increased VTE rate (OR 1.85, 95 % CI 1.07–3.20). WB transfusion, TXA administration, ISS, and MOI did not influence the rate of VTE.</p></div><div><h3>Conclusion</h3><p>These data demonstrate that the combination of WB + TXA administered to trauma patients has no higher risk of VTE than patients who receive PRBC + TXA, a comparison that has not been studied clinically to date. Despite the pro thrombotic state enhanced by TXA and the decreased dilutional coagulopathy seen in WB resuscitation, there was no increased risk of VTE compared to TXA + PRBC. There is no evidence that TXA combined with whole blood transfusion is associated with an increased risk of VTE. However, higher pre-hospital SI was associated with an elevated rate of VTE. These clinical features provide insight into patients who may be at an increased risk of developing VTE and may benefit from targeted prevention strategies.</p></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142144974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-27DOI: 10.1016/j.amjsurg.2024.115934
Michael Kell, Susan You, Amy Goldberg, Daohai Yu, Xiaoning Lu, Jessica Beard, Thomas Santora, Zoe Maher, Jeffrey Anderson, Cristina Novak, Christina Jacovides, Abhijit Pathak, Elizabeth Dauer
{"title":"False reassurances: Mortality risks in penetrating trauma patients with verbal GCS ≥3.","authors":"Michael Kell, Susan You, Amy Goldberg, Daohai Yu, Xiaoning Lu, Jessica Beard, Thomas Santora, Zoe Maher, Jeffrey Anderson, Cristina Novak, Christina Jacovides, Abhijit Pathak, Elizabeth Dauer","doi":"10.1016/j.amjsurg.2024.115934","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2024.115934","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142144970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-23DOI: 10.1016/j.amjsurg.2024.115929
Young Jae Ryu, Shawn Y Hsu, Eric J Kuo, Rachel Liou, Catherine M McManus, James A Lee, Jennifer H Kuo
Background: The efficacy of radiofrequency ablation (RFA) in treating thyroid nodules with indeterminate cytology remains less studied. The objective of this study was to determine the efficacy of RFA in treating nodules with Bethesda III that have been molecularly profiled benign (BIII-MPN).
Methods: We included prospectively enrolled patients who underwent RFA for benign and BIII-MPN thyroid nodules. Primary outcome measures were volume reduction ratio (VRR), symptom score (range 0-10), and cosmetic score (range 0-3) at 1, 3, 6, and 12 months after RFA, as well as complication rates.
Results: A total of 258 nodules in 192 patients were included (benign: 238 in 174; BIII-MPN: 20 in 18). The median VRR differed insignificantly, whereas symptom and cosmetic score improvements were similar between two cohorts. BIII-MPN thyroid nodules were associated with lower rates of infection and temporary voice change.
Conclusion: Our preliminary findings suggest that RFA may be a feasible management option for BIII-MPN thyroid nodules. However, appropriate will be important to address the important risk of potentially missed malignancies.
{"title":"Radiofrequency ablation of Bethesda category III thyroid nodules with benign molecular testing: Preliminary findings from a single institution.","authors":"Young Jae Ryu, Shawn Y Hsu, Eric J Kuo, Rachel Liou, Catherine M McManus, James A Lee, Jennifer H Kuo","doi":"10.1016/j.amjsurg.2024.115929","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2024.115929","url":null,"abstract":"<p><strong>Background: </strong>The efficacy of radiofrequency ablation (RFA) in treating thyroid nodules with indeterminate cytology remains less studied. The objective of this study was to determine the efficacy of RFA in treating nodules with Bethesda III that have been molecularly profiled benign (BIII-MPN).</p><p><strong>Methods: </strong>We included prospectively enrolled patients who underwent RFA for benign and BIII-MPN thyroid nodules. Primary outcome measures were volume reduction ratio (VRR), symptom score (range 0-10), and cosmetic score (range 0-3) at 1, 3, 6, and 12 months after RFA, as well as complication rates.</p><p><strong>Results: </strong>A total of 258 nodules in 192 patients were included (benign: 238 in 174; BIII-MPN: 20 in 18). The median VRR differed insignificantly, whereas symptom and cosmetic score improvements were similar between two cohorts. BIII-MPN thyroid nodules were associated with lower rates of infection and temporary voice change.</p><p><strong>Conclusion: </strong>Our preliminary findings suggest that RFA may be a feasible management option for BIII-MPN thyroid nodules. However, appropriate will be important to address the important risk of potentially missed malignancies.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-23DOI: 10.1016/j.amjsurg.2024.115926
Background
For older adults undergoing surgery, returning home is instrumental for functional independence. We quantified octogenarians unable to return home by POD-30, assessed geriatric factors in a predictive model, and identified risk factors to inform decision-making and quality improvement.
Methods
This retrospective cohort study examined patients ≥80 years old from the ACS NSQIP Geriatric Surgery Pilot, using sequential logistic regression modelling. The primary outcome was non-home living location at POD-30.
Results
Of 4946 patients, 19.8 % lived in non-home facilities at POD-30. Increased odds of non-home living location were seen in patients with preoperative fall history (OR 2.92, 95%CI 2.06–4.14) and new postoperative pressure ulcer (OR 2.66, 95%CI 1.50–4.71) Other significant geriatric-specific risk factors included mobility aid use, surrogate-signed consent, and postoperative delirium, with odds ratios ranging from 1.42 (1.19–1.68) to 1.97 (1.53–2.53).
Conclusions
These geriatric-specific risk factors highlight the importance of preoperative vulnerability screening and intervention to inform surgical decision-making.
{"title":"Octogenarians unable to return home by postoperative-day 30","authors":"","doi":"10.1016/j.amjsurg.2024.115926","DOIUrl":"10.1016/j.amjsurg.2024.115926","url":null,"abstract":"<div><h3>Background</h3><p>For older adults undergoing surgery, returning home is instrumental for functional independence. We quantified octogenarians unable to return home by POD-30, assessed geriatric factors in a predictive model, and identified risk factors to inform decision-making and quality improvement.</p></div><div><h3>Methods</h3><p>This retrospective cohort study examined patients ≥80 years old from the ACS NSQIP Geriatric Surgery Pilot, using sequential logistic regression modelling. The primary outcome was non-home living location at POD-30.</p></div><div><h3>Results</h3><p>Of 4946 patients, 19.8 % lived in non-home facilities at POD-30. Increased odds of non-home living location were seen in patients with preoperative fall history (OR 2.92, 95%CI 2.06–4.14) and new postoperative pressure ulcer (OR 2.66, 95%CI 1.50–4.71) Other significant geriatric-specific risk factors included mobility aid use, surrogate-signed consent, and postoperative delirium, with odds ratios ranging from 1.42 (1.19–1.68) to 1.97 (1.53–2.53).</p></div><div><h3>Conclusions</h3><p>These geriatric-specific risk factors highlight the importance of preoperative vulnerability screening and intervention to inform surgical decision-making.</p></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142270475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Single-site studies have found variable associations between gender and entrustment-based interactions during surgical residency. We sought to assess the relationship between resident sex and intraoperative entrustment at multiple institutions.
Methods: Surgical cases were observed at four university-based training programs. Faculty entrustment and resident entrustability were rated using OpTrust. OpTrust is a validated intraoperative entrustment measurement tool which enables trained third-party raters to objectively score resident and faculty behaviors in the operating room. Independent sample t-tests and regression analysis with cluster adjusted standard errors were used.
Results: 337 cases were observed which included 149 residents (54 % female) and 97 faculty members (30 % female). There was no difference in resident entrustability based on resident sex (p = 0.30). Female residents were more likely to be involved in cases rated as more difficult (p = 0.04). At a single site, male residents scored higher on resident entrustability (p = 0.007) and faculty entrustment (p = 0.022).
Conclusion: Entrustment did not differ based on resident sex on a multi-institutional scale; however, at a single site, there was a difference; suggesting there are multi-factorial issues contributing to differences in training.
{"title":"Multi-institutional study examining intraoperative entrustment and resident sex.","authors":"Samantha Baker, Julie Evans, Niki Matusko, Brenessa Lindeman, Sarah Jung, Sebin Choi, Rebecca Minter, Mackenzie Cook, Karen Brasel, Gurjit Sandhu","doi":"10.1016/j.amjsurg.2024.115925","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2024.115925","url":null,"abstract":"<p><strong>Introduction: </strong>Single-site studies have found variable associations between gender and entrustment-based interactions during surgical residency. We sought to assess the relationship between resident sex and intraoperative entrustment at multiple institutions.</p><p><strong>Methods: </strong>Surgical cases were observed at four university-based training programs. Faculty entrustment and resident entrustability were rated using OpTrust. OpTrust is a validated intraoperative entrustment measurement tool which enables trained third-party raters to objectively score resident and faculty behaviors in the operating room. Independent sample t-tests and regression analysis with cluster adjusted standard errors were used.</p><p><strong>Results: </strong>337 cases were observed which included 149 residents (54 % female) and 97 faculty members (30 % female). There was no difference in resident entrustability based on resident sex (p = 0.30). Female residents were more likely to be involved in cases rated as more difficult (p = 0.04). At a single site, male residents scored higher on resident entrustability (p = 0.007) and faculty entrustment (p = 0.022).</p><p><strong>Conclusion: </strong>Entrustment did not differ based on resident sex on a multi-institutional scale; however, at a single site, there was a difference; suggesting there are multi-factorial issues contributing to differences in training.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142144972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-22DOI: 10.1016/j.amjsurg.2024.115913
Jan J Dekker, Arkadii P Sipok, Katherine A Shelton
{"title":"Comparison of emergency general surgery at a tertiary and community hospital: One surgeon's perspective.","authors":"Jan J Dekker, Arkadii P Sipok, Katherine A Shelton","doi":"10.1016/j.amjsurg.2024.115913","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2024.115913","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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