Surgeon

8/29/06

A study published in the September issue of the Annals of Surgery found that for some complex cardiovascular and cancer surgical procedures, surgeons older than 60 with low surgical volumes had higher patient mortality rates than their younger counterparts. However, older surgeons who continued to maintain higher surgical case loads had outcomes comparable to peers ages 41 to 50. The study also dispels the belief that younger, less experienced surgeons are more likely to have poor surgical outcomes.

“This study’s results should be very encouraging not only for patients, but also for younger and older surgeons whose operative skills may previously have been the subject of scrutiny,” says Jennifer F. Waljee, MD, MPH, general surgery resident in the Department of Surgery of the University of Michigan Medical School and lead author. “The bottom line is that for most procedures the age of the surgeon is not an important predictor of operative risk for a patient. The effect of surgeon age was largely limited to those surgeons with lower procedure volumes.”

For the study, surgeons were placed into three age groups: 40 years and younger, ages 41 to 50, and 60 years and older. A total of 460,738 Medicare patients who underwent coronary artery bypass grafting, elective abdominal aortic aneurysm repair, aortic valve replacement, carotid endarterectomy, pancreatectomy, esophagectomy, lung resection, and cystectomy were used in the study.

Patient operative mortality—death before discharge or within 30 days of surgery—was reviewed for each patient. Factors such as surgeon procedure volume, hospital surgery volume, and the hospital’s teaching status were also evaluated.

The results found that surgeons over 60 were found to have higher patient mortality rates when compared to the rates of surgeons aged 41 to 50 for three of the eight procedures—pancreatectomy, coronary artery bypass grafting, and carotid endarterectomy. Surgeon age was not related to mortality for the other procedures.

The researchers also found that the younger surgeons—those under 40—had comparable mortality to surgeons between 41 and 50.

Future research will be conducted to determine whether specific mechanisms of aging (physical and mental stamina, vision, and motor skills) affect low-volume surgeons’ performance.

[www.newswise.com, August 24, 2006]