Evaluating the Impact of Operative Team Familiarity on Cardiac Surgery Outcomes: A Retrospective Cohort Study of Medicare Beneficiaries
To associate surgeon-anesthesiologist team familiarity (TF) with cardiac surgery outcomes. TF, a measure of repeated team member collaborations, has been associated with improved operative efficiency; however, examination of its relationship to clinical outcomes has been limited. This retrospective...
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| Veröffentlicht in: | Annals of surgery 2024-05, Vol.279 (5), p.891-899 |
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| creator | Awtry, Jake A Abernathy, James H Wu, Xiaoting Yang, Jie Zhang, Min Hou, Hechuan Kaneko, Tsuyoshi de la Cruz, Kim I Stakich-Alpirez, Korana Yule, Steven Cleveland, Jr, Joseph C Shook, Douglas C Fitzsimons, Michael G Harrington, Steven D Pagani, Francis D Likosky, Donald S |
| description | To associate surgeon-anesthesiologist team familiarity (TF) with cardiac surgery outcomes.
TF, a measure of repeated team member collaborations, has been associated with improved operative efficiency; however, examination of its relationship to clinical outcomes has been limited.
This retrospective cohort study included Medicare beneficiaries undergoing coronary artery bypass grafting (CABG), surgical aortic valve replacement (SAVR), or both (CABG+SAVR) between January 1, 2017, and September 30, 2018. TF was defined as the number of shared procedures between the cardiac surgeon and anesthesiologist within 6 months of each operation. Primary outcomes were 30- and 90-day mortality, composite morbidity, and 30-day mortality or composite morbidity, assessed before and after risk adjustment using multivariable logistic regression.
The cohort included 113,020 patients (84,397 CABG; 15,939 SAVR; 12,684 CABG+SAVR). Surgeon-anesthesiologist dyads in the highest [31631 patients, TF median (interquartile range)=8 (6, 11)] and lowest [44,307 patients, TF=0 (0, 1)] TF terciles were termed familiar and unfamiliar, respectively. The rates of observed outcomes were lower among familiar versus unfamiliar teams: 30-day mortality (2.8% vs 3.1%, P =0.001), 90-day mortality (4.2% vs 4.5%, P =0.023), composite morbidity (57.4% vs 60.6%, P |
| doi_str_mv | 10.1097/SLA.0000000000006100 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2869615596</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2869615596</sourcerecordid><originalsourceid>FETCH-LOGICAL-c256t-f81bb1569590364567e07e91989bbe5bc0fc5335e24db2ed505e5372d6499f6a3</originalsourceid><addsrcrecordid>eNpdUdFKwzAUDaK4Of0DkTz60pk0Tdr4NsemwmTg5nNJ09st0q41SQf7An_bzk0R78uFwznncu5B6JqSISUyvlvMRkPyZwQl5AT1KQ-TgNKInKJ-h7IgkizsoQvn3gmhUULic9RjccyZ4HEffU62qmyVN5sV9mvAz1WjtMd1gecN2A7fAl6CqvBUVaY0yhq_w_UGj5XNjdJ40doV2B2et17XFbh7PMKv4G3tGtDf6nG9rq3HC9_mu73vC-RGKwv4ATZQGL33BHeJzgpVOrg67gF6m06W46dgNn98Ho9mgQ658EGR0CyjXEguCRMRFzGQGCSVicwy4JkmheaMcQijPAsh54QDZ3GYi0jKQig2QLcH38bWHy04n1bGaShLtYG6dWmYCCko51J01OhA1V0aZ6FIG2sqZXcpJem-grSrIP1fQSe7OV5oswryX9HPz9kXrayCXA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2869615596</pqid></control><display><type>article</type><title>Evaluating the Impact of Operative Team Familiarity on Cardiac Surgery Outcomes: A Retrospective Cohort Study of Medicare Beneficiaries</title><source>PubMed Central</source><source>Journals@Ovid Complete</source><creator>Awtry, Jake A ; Abernathy, James H ; Wu, Xiaoting ; Yang, Jie ; Zhang, Min ; Hou, Hechuan ; Kaneko, Tsuyoshi ; de la Cruz, Kim I ; Stakich-Alpirez, Korana ; Yule, Steven ; Cleveland, Jr, Joseph C ; Shook, Douglas C ; Fitzsimons, Michael G ; Harrington, Steven D ; Pagani, Francis D ; Likosky, Donald S</creator><creatorcontrib>Awtry, Jake A ; Abernathy, James H ; Wu, Xiaoting ; Yang, Jie ; Zhang, Min ; Hou, Hechuan ; Kaneko, Tsuyoshi ; de la Cruz, Kim I ; Stakich-Alpirez, Korana ; Yule, Steven ; Cleveland, Jr, Joseph C ; Shook, Douglas C ; Fitzsimons, Michael G ; Harrington, Steven D ; Pagani, Francis D ; Likosky, Donald S ; Video Assessment of caRdiac Surgery qualITY (VARSITY) Surgery Investigators ; on behalf of the Video Assessment of caRdiac Surgery qualITY (VARSITY) Surgery Investigators</creatorcontrib><description>To associate surgeon-anesthesiologist team familiarity (TF) with cardiac surgery outcomes.
TF, a measure of repeated team member collaborations, has been associated with improved operative efficiency; however, examination of its relationship to clinical outcomes has been limited.
This retrospective cohort study included Medicare beneficiaries undergoing coronary artery bypass grafting (CABG), surgical aortic valve replacement (SAVR), or both (CABG+SAVR) between January 1, 2017, and September 30, 2018. TF was defined as the number of shared procedures between the cardiac surgeon and anesthesiologist within 6 months of each operation. Primary outcomes were 30- and 90-day mortality, composite morbidity, and 30-day mortality or composite morbidity, assessed before and after risk adjustment using multivariable logistic regression.
The cohort included 113,020 patients (84,397 CABG; 15,939 SAVR; 12,684 CABG+SAVR). Surgeon-anesthesiologist dyads in the highest [31631 patients, TF median (interquartile range)=8 (6, 11)] and lowest [44,307 patients, TF=0 (0, 1)] TF terciles were termed familiar and unfamiliar, respectively. The rates of observed outcomes were lower among familiar versus unfamiliar teams: 30-day mortality (2.8% vs 3.1%, P =0.001), 90-day mortality (4.2% vs 4.5%, P =0.023), composite morbidity (57.4% vs 60.6%, P <0.001), and 30-day mortality or composite morbidity (57.9% vs 61.1%, P <0.001). Familiar teams had lower overall risk-adjusted odds of 30-day mortality or composite morbidity [adjusted odds ratio (aOR) 0.894 (0.868, 0.922), P <0.001], and for SAVR significantly lower 30-day mortality [aOR 0.724 (0.547, 0.959), P =0.024], 90-day mortality [aOR 0.779 (0.620, 0.978), P =0.031], and 30-day mortality or composite morbidity [aOR 0.856 (0.791, 0.927), P <0.001].
Given its relationship with improved 30-day cardiac surgical outcomes, increasing TF should be considered among strategies to advance patient outcomes.</description><identifier>ISSN: 0003-4932</identifier><identifier>EISSN: 1528-1140</identifier><identifier>DOI: 10.1097/SLA.0000000000006100</identifier><identifier>PMID: 37753657</identifier><language>eng</language><publisher>United States</publisher><ispartof>Annals of surgery, 2024-05, Vol.279 (5), p.891-899</ispartof><rights>Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c256t-f81bb1569590364567e07e91989bbe5bc0fc5335e24db2ed505e5372d6499f6a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37753657$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Awtry, Jake A</creatorcontrib><creatorcontrib>Abernathy, James H</creatorcontrib><creatorcontrib>Wu, Xiaoting</creatorcontrib><creatorcontrib>Yang, Jie</creatorcontrib><creatorcontrib>Zhang, Min</creatorcontrib><creatorcontrib>Hou, Hechuan</creatorcontrib><creatorcontrib>Kaneko, Tsuyoshi</creatorcontrib><creatorcontrib>de la Cruz, Kim I</creatorcontrib><creatorcontrib>Stakich-Alpirez, Korana</creatorcontrib><creatorcontrib>Yule, Steven</creatorcontrib><creatorcontrib>Cleveland, Jr, Joseph C</creatorcontrib><creatorcontrib>Shook, Douglas C</creatorcontrib><creatorcontrib>Fitzsimons, Michael G</creatorcontrib><creatorcontrib>Harrington, Steven D</creatorcontrib><creatorcontrib>Pagani, Francis D</creatorcontrib><creatorcontrib>Likosky, Donald S</creatorcontrib><creatorcontrib>Video Assessment of caRdiac Surgery qualITY (VARSITY) Surgery Investigators</creatorcontrib><creatorcontrib>on behalf of the Video Assessment of caRdiac Surgery qualITY (VARSITY) Surgery Investigators</creatorcontrib><title>Evaluating the Impact of Operative Team Familiarity on Cardiac Surgery Outcomes: A Retrospective Cohort Study of Medicare Beneficiaries</title><title>Annals of surgery</title><addtitle>Ann Surg</addtitle><description>To associate surgeon-anesthesiologist team familiarity (TF) with cardiac surgery outcomes.
TF, a measure of repeated team member collaborations, has been associated with improved operative efficiency; however, examination of its relationship to clinical outcomes has been limited.
This retrospective cohort study included Medicare beneficiaries undergoing coronary artery bypass grafting (CABG), surgical aortic valve replacement (SAVR), or both (CABG+SAVR) between January 1, 2017, and September 30, 2018. TF was defined as the number of shared procedures between the cardiac surgeon and anesthesiologist within 6 months of each operation. Primary outcomes were 30- and 90-day mortality, composite morbidity, and 30-day mortality or composite morbidity, assessed before and after risk adjustment using multivariable logistic regression.
The cohort included 113,020 patients (84,397 CABG; 15,939 SAVR; 12,684 CABG+SAVR). Surgeon-anesthesiologist dyads in the highest [31631 patients, TF median (interquartile range)=8 (6, 11)] and lowest [44,307 patients, TF=0 (0, 1)] TF terciles were termed familiar and unfamiliar, respectively. The rates of observed outcomes were lower among familiar versus unfamiliar teams: 30-day mortality (2.8% vs 3.1%, P =0.001), 90-day mortality (4.2% vs 4.5%, P =0.023), composite morbidity (57.4% vs 60.6%, P <0.001), and 30-day mortality or composite morbidity (57.9% vs 61.1%, P <0.001). Familiar teams had lower overall risk-adjusted odds of 30-day mortality or composite morbidity [adjusted odds ratio (aOR) 0.894 (0.868, 0.922), P <0.001], and for SAVR significantly lower 30-day mortality [aOR 0.724 (0.547, 0.959), P =0.024], 90-day mortality [aOR 0.779 (0.620, 0.978), P =0.031], and 30-day mortality or composite morbidity [aOR 0.856 (0.791, 0.927), P <0.001].
Given its relationship with improved 30-day cardiac surgical outcomes, increasing TF should be considered among strategies to advance patient outcomes.</description><issn>0003-4932</issn><issn>1528-1140</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNpdUdFKwzAUDaK4Of0DkTz60pk0Tdr4NsemwmTg5nNJ09st0q41SQf7An_bzk0R78uFwznncu5B6JqSISUyvlvMRkPyZwQl5AT1KQ-TgNKInKJ-h7IgkizsoQvn3gmhUULic9RjccyZ4HEffU62qmyVN5sV9mvAz1WjtMd1gecN2A7fAl6CqvBUVaY0yhq_w_UGj5XNjdJ40doV2B2et17XFbh7PMKv4G3tGtDf6nG9rq3HC9_mu73vC-RGKwv4ATZQGL33BHeJzgpVOrg67gF6m06W46dgNn98Ho9mgQ658EGR0CyjXEguCRMRFzGQGCSVicwy4JkmheaMcQijPAsh54QDZ3GYi0jKQig2QLcH38bWHy04n1bGaShLtYG6dWmYCCko51J01OhA1V0aZ6FIG2sqZXcpJem-grSrIP1fQSe7OV5oswryX9HPz9kXrayCXA</recordid><startdate>20240501</startdate><enddate>20240501</enddate><creator>Awtry, Jake A</creator><creator>Abernathy, James H</creator><creator>Wu, Xiaoting</creator><creator>Yang, Jie</creator><creator>Zhang, Min</creator><creator>Hou, Hechuan</creator><creator>Kaneko, Tsuyoshi</creator><creator>de la Cruz, Kim I</creator><creator>Stakich-Alpirez, Korana</creator><creator>Yule, Steven</creator><creator>Cleveland, Jr, Joseph C</creator><creator>Shook, Douglas C</creator><creator>Fitzsimons, Michael G</creator><creator>Harrington, Steven D</creator><creator>Pagani, Francis D</creator><creator>Likosky, Donald S</creator><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20240501</creationdate><title>Evaluating the Impact of Operative Team Familiarity on Cardiac Surgery Outcomes: A Retrospective Cohort Study of Medicare Beneficiaries</title><author>Awtry, Jake A ; Abernathy, James H ; Wu, Xiaoting ; Yang, Jie ; Zhang, Min ; Hou, Hechuan ; Kaneko, Tsuyoshi ; de la Cruz, Kim I ; Stakich-Alpirez, Korana ; Yule, Steven ; Cleveland, Jr, Joseph C ; Shook, Douglas C ; Fitzsimons, Michael G ; Harrington, Steven D ; Pagani, Francis D ; Likosky, Donald S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c256t-f81bb1569590364567e07e91989bbe5bc0fc5335e24db2ed505e5372d6499f6a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Awtry, Jake A</creatorcontrib><creatorcontrib>Abernathy, James H</creatorcontrib><creatorcontrib>Wu, Xiaoting</creatorcontrib><creatorcontrib>Yang, Jie</creatorcontrib><creatorcontrib>Zhang, Min</creatorcontrib><creatorcontrib>Hou, Hechuan</creatorcontrib><creatorcontrib>Kaneko, Tsuyoshi</creatorcontrib><creatorcontrib>de la Cruz, Kim I</creatorcontrib><creatorcontrib>Stakich-Alpirez, Korana</creatorcontrib><creatorcontrib>Yule, Steven</creatorcontrib><creatorcontrib>Cleveland, Jr, Joseph C</creatorcontrib><creatorcontrib>Shook, Douglas C</creatorcontrib><creatorcontrib>Fitzsimons, Michael G</creatorcontrib><creatorcontrib>Harrington, Steven D</creatorcontrib><creatorcontrib>Pagani, Francis D</creatorcontrib><creatorcontrib>Likosky, Donald S</creatorcontrib><creatorcontrib>Video Assessment of caRdiac Surgery qualITY (VARSITY) Surgery Investigators</creatorcontrib><creatorcontrib>on behalf of the Video Assessment of caRdiac Surgery qualITY (VARSITY) Surgery Investigators</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Awtry, Jake A</au><au>Abernathy, James H</au><au>Wu, Xiaoting</au><au>Yang, Jie</au><au>Zhang, Min</au><au>Hou, Hechuan</au><au>Kaneko, Tsuyoshi</au><au>de la Cruz, Kim I</au><au>Stakich-Alpirez, Korana</au><au>Yule, Steven</au><au>Cleveland, Jr, Joseph C</au><au>Shook, Douglas C</au><au>Fitzsimons, Michael G</au><au>Harrington, Steven D</au><au>Pagani, Francis D</au><au>Likosky, Donald S</au><aucorp>Video Assessment of caRdiac Surgery qualITY (VARSITY) Surgery Investigators</aucorp><aucorp>on behalf of the Video Assessment of caRdiac Surgery qualITY (VARSITY) Surgery Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evaluating the Impact of Operative Team Familiarity on Cardiac Surgery Outcomes: A Retrospective Cohort Study of Medicare Beneficiaries</atitle><jtitle>Annals of surgery</jtitle><addtitle>Ann Surg</addtitle><date>2024-05-01</date><risdate>2024</risdate><volume>279</volume><issue>5</issue><spage>891</spage><epage>899</epage><pages>891-899</pages><issn>0003-4932</issn><eissn>1528-1140</eissn><abstract>To associate surgeon-anesthesiologist team familiarity (TF) with cardiac surgery outcomes.
TF, a measure of repeated team member collaborations, has been associated with improved operative efficiency; however, examination of its relationship to clinical outcomes has been limited.
This retrospective cohort study included Medicare beneficiaries undergoing coronary artery bypass grafting (CABG), surgical aortic valve replacement (SAVR), or both (CABG+SAVR) between January 1, 2017, and September 30, 2018. TF was defined as the number of shared procedures between the cardiac surgeon and anesthesiologist within 6 months of each operation. Primary outcomes were 30- and 90-day mortality, composite morbidity, and 30-day mortality or composite morbidity, assessed before and after risk adjustment using multivariable logistic regression.
The cohort included 113,020 patients (84,397 CABG; 15,939 SAVR; 12,684 CABG+SAVR). Surgeon-anesthesiologist dyads in the highest [31631 patients, TF median (interquartile range)=8 (6, 11)] and lowest [44,307 patients, TF=0 (0, 1)] TF terciles were termed familiar and unfamiliar, respectively. The rates of observed outcomes were lower among familiar versus unfamiliar teams: 30-day mortality (2.8% vs 3.1%, P =0.001), 90-day mortality (4.2% vs 4.5%, P =0.023), composite morbidity (57.4% vs 60.6%, P <0.001), and 30-day mortality or composite morbidity (57.9% vs 61.1%, P <0.001). Familiar teams had lower overall risk-adjusted odds of 30-day mortality or composite morbidity [adjusted odds ratio (aOR) 0.894 (0.868, 0.922), P <0.001], and for SAVR significantly lower 30-day mortality [aOR 0.724 (0.547, 0.959), P =0.024], 90-day mortality [aOR 0.779 (0.620, 0.978), P =0.031], and 30-day mortality or composite morbidity [aOR 0.856 (0.791, 0.927), P <0.001].
Given its relationship with improved 30-day cardiac surgical outcomes, increasing TF should be considered among strategies to advance patient outcomes.</abstract><cop>United States</cop><pmid>37753657</pmid><doi>10.1097/SLA.0000000000006100</doi><tpages>9</tpages></addata></record> |
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| title | Evaluating the Impact of Operative Team Familiarity on Cardiac Surgery Outcomes: A Retrospective Cohort Study of Medicare Beneficiaries |
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