Surgical Registrars as Primary Operators Have Acceptable Outcomes for Trauma Laparotomy
Abstract
:1. Introduction
2. Materials and Methods
2.1. Clinical Setting
2.2. The Study
2.3. Statistical Analysis
3. Results
3.1. Overview
3.2. Primary Operator
3.3. Clinical Outcome
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Registrar Assisting Consultant | Registrar as Primary Operator with Consultant Present | Registrar as Primary Operator with No Consultant Present | p-Value | |
---|---|---|---|---|
n (%) | 98 (48) | 55 (27) | 44 (22) | |
Mean PGY Level (±SD) | 10 (±5) | 12 (±5) | 14 (±4) | <0.0001 * |
Demographics | ||||
Age (±SD) | 40 (±19) | 38 (±17) | 40 (±18) | 0.79 |
Male (%) | 60 (61) | 35 (64) | 31 (70) | 0.85 |
Female (%) | 38 (39) | 20 (36) | 13 (30) | |
Physiology (±SD) | ||||
HR | 102 (±26) | 97 (±25) | 89 (±25) | 0.02 * |
SBP | 101 (±27) | 118 (±31) | 122 (±24) | <0.0001 * |
Shock Index | 1.1 (±0.5) | 0.9 (±0.4) | 0.8 (±0.3) | <0.0003 * |
pH | 7.27 (±0.11) | 7.30 (±0.09) | 7.30 (±0.12) | 0.15 |
Lactate | 3.6 (±2.6) | 2.9 (±2) | 2.5 (±2.2) | 0.025 * |
BE | −5.2 (±4.9) | −3.4 (±4.6) | −3.9 (±4.6) | 0.06 |
Mechanism (%) | ||||
Blunt | 82 (84) | 44 (80) | 38 (86) | 0.87 |
Penetrating | 16 (16) | 11 (20) | 6 (14) | |
GSW | 5 (5) | 5 (9) | 0 (0) | 0.073 |
SW | 11 (11) | 5 (11) | 6 (14) | 0.92 |
Mean ISS (±SD) | 23 (±13) | 23 (±15) | 23 (±15) | 1 |
Organ Injury (%) | ||||
Diaphragm | 13 (13) | 5 (9) | 3 (7) | 0.68 |
Liver | 28 (29) | 14 (25) | 8 (18) | 0.61 |
Gallbladder | 0 (0) | 3 (5) | 0 (0) | 0.0018 ^ |
Spleen | 33 (34) | 15 (27) | 11 (25) | 0.72 |
Pancreas | 4 (4) | 2 (4) | 1 (2) | 1 |
Stomach | 6 (6) | 3 95) | 1 (2) | 0.82 |
Small Bowel | 33 (34) | 18 (33) | 15 (34) | 1 |
Large Bowel | 33 (34) | 12 (22) | 13 (30) | 0.44 |
Kidney | 4 (4) | 3 (5) | 1 (2) | 0.91 |
Intra-abdominal vasculature | 13 (13) | 3 (5) | 1 (2) | 0.043 ^ |
Registrar Assisting Consultant | Registrar as Primary Operator with Consultant Present | Registrar as Primary Operator with No Consultant Present | p-Value | |
---|---|---|---|---|
Outcome | ||||
Mean length of stay (±SD) | 21 (±30) | 17 (±14) | 16 (±15) | 0.41 |
Mortality (%) | 6 (6) | 3 (5) | 1 (2) | 0.82 |
Morbidity (%) | 36 (37) | 24 (44) | 13 (28) | 0.55 |
Anastomotic Leak | 1 (1) | 2 (4) | 0 (0) | 0.36 |
Respiratory | 9 (9) | 10 (18) | 4 (9) | 0.25 |
Wound | 9 (9) | 5 (9) | 5 (11) | 0.98 |
Renal | 4 (4) | 1 (2) | 2 (4) | 0.84 |
Cardiac | 6 (6) | 2 (4) | 1 (2) | 0.82 |
Gastrointestinal | 13 (13) | 11 (20) | 5 (11) | 0.27 |
Other | 5 (5) | 5 (9) | 4 (9) | 0.6 |
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Ko, J.; Kong, V.; Amey, J.; Clarke, D.; Ah Yen, D.; Christey, G. Surgical Registrars as Primary Operators Have Acceptable Outcomes for Trauma Laparotomy. Trauma Care 2022, 2, 205-210. https://doi.org/10.3390/traumacare2020017
Ko J, Kong V, Amey J, Clarke D, Ah Yen D, Christey G. Surgical Registrars as Primary Operators Have Acceptable Outcomes for Trauma Laparotomy. Trauma Care. 2022; 2(2):205-210. https://doi.org/10.3390/traumacare2020017
Chicago/Turabian StyleKo, Jonathan, Victor Kong, Janet Amey, Damian Clarke, Damien Ah Yen, and Grant Christey. 2022. "Surgical Registrars as Primary Operators Have Acceptable Outcomes for Trauma Laparotomy" Trauma Care 2, no. 2: 205-210. https://doi.org/10.3390/traumacare2020017