Resident Involvement in Shoulder Arthroscopy Is Not Associated With Short-term Risk to Patients

Abstract

Background:Shoulder arthroscopy is a commonly performed, critical component of orthopaedic residency training. However, it is unclear whether there are additional risks to patients in cases associated with resident involvement.Purpose:To compare shoulder arthroscopy cases with and without resident involvement via a large, prospectively maintained national surgical registry to characterize perioperative risks.Study Design:Cohort study; Level of evidence, 3.Methods:The prospectively maintained American College of Surgeons National Surgical Quality Improvement Program registry was queried to identify patients who underwent 1 of 12 shoulder arthroscopy procedures from 2005 through 2012. Multivariate Poisson regression with robust error variance was used to compare the rates of postoperative adverse events and readmission within 30 days between cases with and without resident involvement. Multivariate linear regression was used to compare operative time between cohorts.Results:A total of 15,774 patients with shoulder arthroscopy were included in the study, and 12.3% of these had a resident involved with the case. The overall rate of adverse events was 1.09%. On multivariate analysis, resident involvement was not associated with increased rates of any aggregate or individual adverse event. There was also no association between resident involvement and risk of readmission within 30 days. Resident involvement was not associated with any difference in operative time (P = .219).Conclusion:Resident involvement in shoulder arthroscopy was not associated with increased risk of adverse events, increased operative time, or readmission within 30 days. The results of this study suggest that resident involvement in shoulder arthroscopy cases is a safe method for trainees to learn these procedures.

The Impact of Resident Involvement on Postoperative Complications After Shoulder Arthroscopy: A Propensity-Matched Analysis

“…Using the NSQIP database, Basques et al 23 investigated resident involvement in shoulder arthroscopy. They identified a 1.09% overall complication rate with resident involvement not being associated with complications, adverse events, or 30-day readmission.…”

Resident Involvement in Arthroscopic Knee Surgery Is Not Associated With Increased Short-term Risk to Patients

“…3,15 Previous studies have investigated the impact of resident involvement on adverse outcomes and readmissions after spine surgery, total joint arthroplasty, and shoulder arthroscopy. 2,5,7,9,13,14 The purpose of the current study was to use a large national data set to compare operative time, adverse events, and readmission for arthroscopic knee surgery cases with and without resident involvement. Our hypothesis was that operative time, adverse events, and readmissions would not significantly differ between arthroscopic knee surgery cases with and without a resident involved in the performance of the procedure.…”

“… 3 , 15 Previous studies have investigated the impact of resident involvement on adverse outcomes and readmissions after spine surgery, total joint arthroplasty, and shoulder arthroscopy. 2 , 5 , 7 , 9 , 13 , 14 …”

Quantifying the Opportunity Cost of Resident Involvement in Academic Orthopaedic Sports Medicine: A Matched-Pair Analysis

“…Although a variety of studies have previously used the American College of Surgeons NSQIP database to examine the impact of resident involvement in orthopaedics, most focused on complication rates and safety, 20,24,[44][45][46][47][48][49] and few studies have examined procedures common in sports medicine. 27,50,51 Basques et al 27 examined the role of resident involvement in shoulder arthroscopy, reporting no change in operative time between attending-only cases and resident-involved cases. However, the findings have limited generalizability to our study because of differences in the date range of data used, variable selection of CPT codes, and no stratification of operative time findings by CPT code.…”

“…Whereas some studies have reported a lower or equal risk of perioperative complications and associations with care for more medically complex patients, others have reported longer operating times, greater morbidity, and longer hospital stay durations. 20,[23][24][25][26] The impact of resident involvement in academic sports medicine is particularly poorly studied, with few studies examining complications, safety, or operative time 27,28 and only a single study using this data to estimate the cost of resident involvement in rotator cuff surgery. 29 For the aforementioned reasons, the purpose of this study is to quantify the cost of resident involvement in academic sports medicine by examining differences in operative time, relative value units (RVUs) per case, and RVUs per hour between attending-only cases and cases with resident involvement.…”