In the study, relative to the patients operated on by attending physicians only, patients whose surgery involved a resident were on average older, were more likely to be inpatients, had higher Charlson comorbidity scores, and had higher American Society of Anesthesiologists classes.
The mean operative time was 179 minutes when a resident was involved and 135 minutes when the attending physician operated alone, reported Dr. Igwe. There was no significant difference between junior residents (those in postgraduate year 1 or 2) and senior residents (all other years).
The group having a resident involved had significantly higher rates of transfusion with more than 4 U of packed red blood cells (2.0% vs. 0.4%) and readmission (5.5% vs. 2.9%). The difference in transfusion rates was greater for junior residents than for senior residents.
However, the groups were statistically indistinguishable with respect to the proportion of patients having at least one complication, experiencing severe morbidity, dying within 30 days, developing infections or sepsis, or having thromboembolic complications.
"The limitations of this study are largely those of the NSQIP database," Dr. Igwe noted. "We were unable to control for attending surgeon experience, presence of additional trainees in the operating room, or tallying up the intraoperative complications. Also, the degree of resident participation is not clearly defined, and there is no data about the conversion rate from laparoscopic to open cases."
Dr. Igwe disclosed no relevant financial conflicts of interest.