PC110. Academic Productivity in Vascular Surgery Is Associated With Faculty Rank and Gender

Abstract

Objective: This study aimed to develop risk predictive models of 30-day mortality and morbidity after bypass surgery for aortoiliac occlusive disease (AIOD) and to compare their performances with a generalized frailty index.Methods: The American College of Surgeons National Surgical Quality Improvement Program 2012 to 2017 procedure targeted aortoiliac (open) database was queried to identify all patients who had elective bypass for AIOD: femorofemoral bypass, aortofemoral bypass, and axillofemoral bypass. Outcomes assessed included mortality and major morbidity within 30 days postoperatively; major morbidity was defined as pneumonia, unplanned intubation, ventilator support for >48 hours, progressive or acute renal failure, cerebrovascular accidents, cardiac arrest, or myocardial infarction. Demographics, comorbidities, procedure type, and laboratory values were considered for inclusion in the risk predictive models. Parsimonious models were developed by backward stepwise logistic regression with P value <.1 as a variable retention criterion. The predictive strength of these models (C indices) was compared with that of the modified 5-factor frailty index (mFI-5), a general frailty tool determined from diabetes, functional status, history of chronic obstructive pulmonary disease, history of congestive heart failure, and hypertension.Results: A total of 2612 patients (mean age, 65.0 6 10.2 years; 60% male) underwent femorofemoral bypass (1149 [44.0%]), aortofemoral bypass (1138 [43.6%]), and axillofemoral bypass (325 [12.4%]). Overall rate of mortality and major morbidity was 2.0% and 8.5%, respectively. Ten variables were retained for our final risk models (Table). Apart from procedure type, age was the most significant predictor of both mortality and morbidity. Both constructed models demonstrated significantly better discriminative ability (P < .001) on the outcomes of interest compared with the mFI-5 (Fig).Conclusions: Our models outperformed mFI-5 in predicting 30-day mortality and major morbidity in patients with AIOD undergoing elective bypass surgery. Calculators created using these variables can robustly calculate individual patients' postoperative risks and allow better informed consent as well as risk-adjusted comparison of the providers' outcomes.Objective: Publication quality and quantity are frequent measures of academic productivity, which in turn is used to determine promotion and, in some cases, to calculate overall productivity. Studies in other disciplines have found associations among academic rank, division chief productivity, and faculty publication. Furthermore, the projected workforce shortage and recent changes in training paradigms may lead to conflict between clinical volume and academic productivity. Despite the centrality of publication quantity and quality as metrics, no data exist in vascular surgery to help benchmark individuals and identify areas for targeted improvement. We thus sought to determine links among faculty and program characteristics and publication output in the United...