TY - JOUR
T1 - Association Between Surgeon and Anesthesiologist Sex Discordance and Postoperative Outcomes
T2 - A Population-based Cohort Study
AU - Wallis, Christopher J.D.
AU - Jerath, Angela
AU - Kaneshwaran, Kirusanthy
AU - Hallet, Julie
AU - Coburn, Natalie
AU - Wright, Frances C.
AU - Conn, Lesley Gotlib
AU - Bischof, Danielle
AU - Covelli, Andrea
AU - Klaassen, Zachary
AU - Zlotta, Alexandre R.
AU - Kulkarni, Girish S.
AU - Luckenbaugh, Amy N.
AU - Armstrong, Kathleen
AU - Lim, Kelvin
AU - Bass, Barbara
AU - Detsky, Allan S.
AU - Satkunasivam, Raj
N1 - Funding Information:
Disclaimer: This study made use of de-identified data from the iCES Data Repository, which is managed by the Institute for Clinical Evaluative Sciences with support from its funders and partners: Canada's Strategy for Patient-Oriented Research (SPOR), the Ontario SPOR Support Unit, the Canadian Institutes of Health Research and the Government of Ontario. The opinions, results and conclusions reported are those of the authors. No endorsement by ICES or any of its funders or partners is intended or should be inferred. Parts of this material are based on data and information compiled and provided by CiHi. However, the analyses, conclusions, opinions and statements expressed herein are those of the author, and not necessarily those of CIHI.
Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.
PY - 2022/7/1
Y1 - 2022/7/1
N2 - Objective:The aim of this study was to examine the effect of surgeon-anesthesiologist sex discordance on postoperative outcomes.Summary Background Data:Optimal surgical outcomes depend on teamwork, with surgeons and anesthesiologists forming two key components. There are sex and sex-based differences in interpersonal communication and medical practice which may contribute to patients' perioperative outcomes.Methods:We performed a population-based, retrospective cohort study among adult patients undergoing 1 of 25 common elective or emergent surgical procedures from 2007 to 2019 in Ontario, Canada. We assessed the association between differences in sex between surgeon and anesthesiologists (sex discordance) on the primary endpoint of adverse postoperative outcome, defined as death, readmission, or complication within 30-days following surgery using generalized estimating equations.Results:Among 1,165,711 patients treated by 3006 surgeons and 1477 anesthesiologists, 791,819 patients were treated by sex concordant teams (male surgeon/male anesthesiologist: 747,327 and female surgeon/female anesthesiologist: 44,492), whereas 373,892 were sex discordant (male surgeon/female anesthesiologist: 267,330 and female surgeon/male anesthesiologist: 106,562). Overall, 12.3% of patients experienced >1 adverse postoperative outcomes of whom 1.3% died. Sex discordance between surgeon and anesthesiologist was not associated with a significant increased likelihood of composite adverse postoperative outcomes (adjusted odds ratio 1.00, 95% confidence interval 0.97-1.03).Conclusions:We did not demonstrate an association between intraoperative surgeon and anesthesiologist sex discordance on adverse postoperative outcomes in a large patient cohort. Patients, clinicians, and administrators may be reassured that physician sex discordance in operating room teams is unlikely to clinically meaningfully affect patient outcomes after surgery.
AB - Objective:The aim of this study was to examine the effect of surgeon-anesthesiologist sex discordance on postoperative outcomes.Summary Background Data:Optimal surgical outcomes depend on teamwork, with surgeons and anesthesiologists forming two key components. There are sex and sex-based differences in interpersonal communication and medical practice which may contribute to patients' perioperative outcomes.Methods:We performed a population-based, retrospective cohort study among adult patients undergoing 1 of 25 common elective or emergent surgical procedures from 2007 to 2019 in Ontario, Canada. We assessed the association between differences in sex between surgeon and anesthesiologists (sex discordance) on the primary endpoint of adverse postoperative outcome, defined as death, readmission, or complication within 30-days following surgery using generalized estimating equations.Results:Among 1,165,711 patients treated by 3006 surgeons and 1477 anesthesiologists, 791,819 patients were treated by sex concordant teams (male surgeon/male anesthesiologist: 747,327 and female surgeon/female anesthesiologist: 44,492), whereas 373,892 were sex discordant (male surgeon/female anesthesiologist: 267,330 and female surgeon/male anesthesiologist: 106,562). Overall, 12.3% of patients experienced >1 adverse postoperative outcomes of whom 1.3% died. Sex discordance between surgeon and anesthesiologist was not associated with a significant increased likelihood of composite adverse postoperative outcomes (adjusted odds ratio 1.00, 95% confidence interval 0.97-1.03).Conclusions:We did not demonstrate an association between intraoperative surgeon and anesthesiologist sex discordance on adverse postoperative outcomes in a large patient cohort. Patients, clinicians, and administrators may be reassured that physician sex discordance in operating room teams is unlikely to clinically meaningfully affect patient outcomes after surgery.
KW - anesthesiologist
KW - communication
KW - readmission
KW - surgeon
KW - treatment outcome
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U2 - 10.1097/SLA.0000000000005495
DO - 10.1097/SLA.0000000000005495
M3 - Article
C2 - 35703460
AN - SCOPUS:85133228997
SN - 0003-4932
VL - 276
SP - 81
EP - 87
JO - Annals of surgery
JF - Annals of surgery
IS - 1
ER -