Abstract 17707: Urgent And Emergency Cardiac Surgery Can Safely be Performed by Residents-in-training Without Compromising Long-term Survival
Introduction: The long term effects of urgent and emergency surgery performed by cardiothoracic trainees are largely unknown
Hypothesis: Trainee-led and consultant-led emergency/urgent cardiac surgery have equivocal short and long-term outcomes
Methods: We retrospectively analysed prospectively collected data on 13,655 patients who underwent cardiac surgery between June 1999 and June 2015 at our institution. We divided operations into Consultant-led (Group A), Trainee-led without consultant scrubbed (Group B) and Trainee-led with consultant scrubbed (Group C). We compared in-hospital outcomes using multivariate logistic and linear regression. We compared long-term outcomes using cox-regression.
Results: There were 82.9% of patients in Group A, 9.0% in Group B and 8.1% in Group C. Elective cases were 76.9%, Urgent cases were 20.7% and Emergency cases were 2.4% of all procedures performed. From multivariate analysis, trainee-led procedures had longer cross-clamp and bypass times for elective and urgent/emergency cases (p<0.001). However, this did not translate into higher hospital mortality or incidence of post-operative stroke, renal failure, atrial fibrillation, re-opening for bleeding, red-cell transfusion or length of hospital stay (p>0.05). Cox-regression revealed no-significant difference (p=0.149) in long-term survival at 16 years post-discharge between consultant-led and trainee-led cases (see Figure 1).
Conclusions: Urgent and Emergency Cardiac surgery can be safely performed by competent trainees without negatively affecting long-term survival.
Author Disclosures: P. ariyaratnam: None. M. Loubani: None.
- © 2016 by American Heart Association, Inc.