Influence of surgeon's experience and supervision on re-operation rate after hip fracture surgery

Henrik Palm; Steffen Jacobsen; Michael Krasheninnikoff; Nicolai Bang Foss; Henrik Kehlet; Peter Henrik Gebuhr

doi:10.1016/j.injury.2006.07.043

Influence of surgeon's experience and supervision on re-operation rate after hip fracture surgery

Henrik Palm, Steffen Jacobsen, Michael Krasheninnikoff, Nicolai Bang Foss, Henrik Kehlet, Peter Henrik Gebuhr

Department of Clinical Medicine

27 Citations (Scopus)

Abstract

OBJECTIVE: To investigate the influence of the performing surgeon's experience and degree of supervision on re-operation rate among patients admitted with a proximal femoral fracture (PFF). METHODS: Prospective study of 600 consecutive patients with proximal femoral fracture in our multimodal rehabilitation programme, between 2002 and 2004. Re-operation rate was assessed 6 months postoperatively. Surgeons were grouped as unsupervised junior registrars versus experienced surgeons operating or supervising. Fractures were stratified as technically undemanding or demanding. RESULTS: Unsupervised junior registrars operated on 23% (137/600) of all and 15% (56/365) of technically demanding proximal femoral fractures. The latter had a higher re-operation rate within 6 months, compared with the rate when more experienced surgeons were present. In logistic regression analysis combining age, gender, American Society of Anaesthesiologists score, New Mobility Score, time to surgery and type of implant, surgery by unsupervised junior registrars was still a significant independent risk factor for re-operation in technically demanding proximal femoral fractures. CONCLUSION: Unsupervised junior registrars should not operate on technically demanding proximal femoral fractures.

Original language	English
Journal	Injury
Volume	38
Issue number	7
Pages (from-to)	775-9
Number of pages	4
ISSN	0020-1383
DOIs	https://doi.org/10.1016/j.injury.2006.07.043
Publication status	Published - 2006

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Cite this

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title = "Influence of surgeon's experience and supervision on re-operation rate after hip fracture surgery",

abstract = "OBJECTIVE: To investigate the influence of the performing surgeon's experience and degree of supervision on re-operation rate among patients admitted with a proximal femoral fracture (PFF). METHODS: Prospective study of 600 consecutive patients with proximal femoral fracture in our multimodal rehabilitation programme, between 2002 and 2004. Re-operation rate was assessed 6 months postoperatively. Surgeons were grouped as unsupervised junior registrars versus experienced surgeons operating or supervising. Fractures were stratified as technically undemanding or demanding. RESULTS: Unsupervised junior registrars operated on 23% (137/600) of all and 15% (56/365) of technically demanding proximal femoral fractures. The latter had a higher re-operation rate within 6 months, compared with the rate when more experienced surgeons were present. In logistic regression analysis combining age, gender, American Society of Anaesthesiologists score, New Mobility Score, time to surgery and type of implant, surgery by unsupervised junior registrars was still a significant independent risk factor for re-operation in technically demanding proximal femoral fractures. CONCLUSION: Unsupervised junior registrars should not operate on technically demanding proximal femoral fractures.",

author = "Henrik Palm and Steffen Jacobsen and Michael Krasheninnikoff and Foss, {Nicolai Bang} and Henrik Kehlet and Gebuhr, {Peter Henrik}",

year = "2006",

doi = "10.1016/j.injury.2006.07.043",

language = "English",

volume = "38",

pages = "775--9",

journal = "Injury",

issn = "0020-1383",

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TY - JOUR

T1 - Influence of surgeon's experience and supervision on re-operation rate after hip fracture surgery

AU - Palm, Henrik

AU - Jacobsen, Steffen

AU - Krasheninnikoff, Michael

AU - Foss, Nicolai Bang

AU - Kehlet, Henrik

AU - Gebuhr, Peter Henrik

PY - 2006

Y1 - 2006

N2 - OBJECTIVE: To investigate the influence of the performing surgeon's experience and degree of supervision on re-operation rate among patients admitted with a proximal femoral fracture (PFF). METHODS: Prospective study of 600 consecutive patients with proximal femoral fracture in our multimodal rehabilitation programme, between 2002 and 2004. Re-operation rate was assessed 6 months postoperatively. Surgeons were grouped as unsupervised junior registrars versus experienced surgeons operating or supervising. Fractures were stratified as technically undemanding or demanding. RESULTS: Unsupervised junior registrars operated on 23% (137/600) of all and 15% (56/365) of technically demanding proximal femoral fractures. The latter had a higher re-operation rate within 6 months, compared with the rate when more experienced surgeons were present. In logistic regression analysis combining age, gender, American Society of Anaesthesiologists score, New Mobility Score, time to surgery and type of implant, surgery by unsupervised junior registrars was still a significant independent risk factor for re-operation in technically demanding proximal femoral fractures. CONCLUSION: Unsupervised junior registrars should not operate on technically demanding proximal femoral fractures.

AB - OBJECTIVE: To investigate the influence of the performing surgeon's experience and degree of supervision on re-operation rate among patients admitted with a proximal femoral fracture (PFF). METHODS: Prospective study of 600 consecutive patients with proximal femoral fracture in our multimodal rehabilitation programme, between 2002 and 2004. Re-operation rate was assessed 6 months postoperatively. Surgeons were grouped as unsupervised junior registrars versus experienced surgeons operating or supervising. Fractures were stratified as technically undemanding or demanding. RESULTS: Unsupervised junior registrars operated on 23% (137/600) of all and 15% (56/365) of technically demanding proximal femoral fractures. The latter had a higher re-operation rate within 6 months, compared with the rate when more experienced surgeons were present. In logistic regression analysis combining age, gender, American Society of Anaesthesiologists score, New Mobility Score, time to surgery and type of implant, surgery by unsupervised junior registrars was still a significant independent risk factor for re-operation in technically demanding proximal femoral fractures. CONCLUSION: Unsupervised junior registrars should not operate on technically demanding proximal femoral fractures.

U2 - 10.1016/j.injury.2006.07.043

DO - 10.1016/j.injury.2006.07.043

M3 - Journal article

SN - 0020-1383

VL - 38

SP - 775

EP - 779

JO - Injury

JF - Injury

IS - 7

ER -

Influence of surgeon's experience and supervision on re-operation rate after hip fracture surgery

Abstract

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