The effect of surgeon specialization on outcomes after ruptured abdominal aortic aneurysm repair

Hawkins, Alexander T.; Smith, Ann D.; Schaumeier, Maria J.; Vos, Marit S. de; Hevelone, Nathanael D.; Nguyen, Louis L.

doi:10.1016/j.jvs.2014.03.283

Cited by 8 publications

(3 citation statements)

References 23 publications

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“…Studies with the better results (ie, mortality <35%) often abstain from reporting nonintervention rates, [26][27][28][29] thus hampering an immediate comparison of results between studies. Perioperative mortality is invariably higher (>40%) when nonintervention rates are reported.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of ruptured abdominal aortic aneurysms in a well-defined Norwegian population with trends in incidence, intervention rate, and mortality

Reite

Søreide

Ellingsen

et al. 2015

Journal of Vascular Surgery

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We found a stable incidence and mortality rate during a decade. The prehospital death rate was lower (9%), the intervention rate (73%) higher, and the total mortality (68%) lower than in most other studies. Geographic and regional differences may influence the epidemiologic description of rAAA and hence should be taken into consideration in comparing outcomes for in-hospital mortality and intervention rates.

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Section: Discussionmentioning

confidence: 99%

Epidemiology of ruptured abdominal aortic aneurysms in a well-defined Norwegian population with trends in incidence, intervention rate, and mortality

Reite

Søreide

Ellingsen

et al. 2015

Journal of Vascular Surgery

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“…However, optimizing patient scheduling did not influence the complication rate or the number of procedures performed per day [45,46]. There was mixed evidence regarding the surgical resident involvement: most of studies reported either no association [4,23,26,29,[61][62][63][64][65][66][67][68][69][70][71][72][73] or a negative [4,23,25,26,[63][64][65][66][67][68][74][75][76][77][78][79][80][81][82][83][84] influence regarding operative time and surgical safety, whereas few found a positive association [28,30,76]. Disturbing elements [57,[85][86][87][88]…”

Section: Discussionmentioning

confidence: 99%

Operating room organization and surgical performance: a systematic review

Pasquer,

Ducarroz,

Lifante

et al. 2024

Patient Saf Surg

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Background Organizational factors may influence surgical outcomes, regardless of extensively studied factors such as patient preoperative risk and surgical complexity. This study was designed to explore how operating room organization determines surgical performance and to identify gaps in the literature that necessitate further investigation. Methods We conducted a systematic review according to PRISMA guidelines to identify original studies in Pubmed and Scopus from January 1, 2000 to December 31, 2019. Studies evaluating the association between five determinants (team composition, stability, teamwork, work scheduling, disturbing elements) and three outcomes (operative time, patient safety, costs) were included. Methodology was assessed based on criteria such as multicentric investigation, accurate population description, and study design. Results Out of 2625 studies, 76 met inclusion criteria. Of these, 34 (44.7%) investigated surgical team composition, 15 (19.7%) team stability, 11 (14.5%) teamwork, 9 (11.8%) scheduling, and 7 (9.2%) examined the occurrence of disturbing elements in the operating room. The participation of surgical residents appeared to impact patient outcomes. Employing specialized and stable teams in dedicated operating rooms showed improvements in outcomes. Optimization of teamwork reduced operative time, while poor teamwork increased morbidity and costs. Disturbances and communication failures in the operating room negatively affected operative time and surgical safety. Conclusion While limited, existing scientific evidence suggests that operating room staffing and environment significantly influences patient outcomes. Prioritizing further research on these organizational drivers is key to enhancing surgical performance.

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“…En el tratamiento del AAAR, los cirujanos vasculares debidamente entrenados ofrecen menor mortalidad, menor tasa de reoperación y de complicaciones renales y/o cardiacas que cirujanos generales en AAAR [46][47][48] . Adicionalmente, los cirujanos vasculares declaran fuera del alcance quirúrgico a 11% de los AAAR que consultan, comparado con 64% en el caso de los cirujanos no vasculares (2 = 63,74, 1 d.f., p < 0,001) 48 .…”

Section: Especialización De Cirujano Vascularunclassified

Concentración de la cirugía de aneurisma de aorta abdominal roto en centros especializados calificados

et al. 2022

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Concentrating ruptured abdominal aortic aneurysm surgery in specialized centersRuptured abdominal aortic aneurysm (RAAA) is an arterial emergency with an overall mortality of 80%-90% secondary to massive hemorrhage. If a patient with RAAA presents in a primary hospital without resolution capacity, survival will depend on early transfer to a center with adequately trained specialists. This article reviews the evidence supporting the centralization of AAAR treatment in qualified centers, specifying the criteria used for the selection of referral centers and the role of a coordinating unit. Our current referral system, which is based primarily on costs, is also described. Patients with AAAR who consult in non-resolving centers should be rapidly transferred to a qualified referral center, following a transfer protocol, and guided by a coordinating unit acting according to technical and established criteria based on results, quality, and costs. Qualified referral centers should have an accredited vascular surgeon and a high institutional aortic surgery volume, adequate infrastructure, endovascular resolution capacity, support services (intensive care, hemodialysis, etc.) and specialized personnel permanently available.

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The effect of surgeon specialization on outcomes after ruptured abdominal aortic aneurysm repair

Cited by 8 publications

References 23 publications

Epidemiology of ruptured abdominal aortic aneurysms in a well-defined Norwegian population with trends in incidence, intervention rate, and mortality

Epidemiology of ruptured abdominal aortic aneurysms in a well-defined Norwegian population with trends in incidence, intervention rate, and mortality

Operating room organization and surgical performance: a systematic review

Concentración de la cirugía de aneurisma de aorta abdominal roto en centros especializados calificados

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