Influence of surgeon's experience and supervision on re-operation rate after hip fracture surgery
Summary 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 multim...
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| Veröffentlicht in: | Injury 2007-07, Vol.38 (7), p.775-779 |
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| creator | Palm, Henrik Jacobsen, Steffen Krasheninnikoff, Michael Foss, Nicolai Bang Kehlet, Henrik Gebuhr, Peter |
| description | Summary 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. |
| doi_str_mv | 10.1016/j.injury.2006.07.043 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_70593512</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0020138306004736</els_id><sourcerecordid>19469660</sourcerecordid><originalsourceid>FETCH-LOGICAL-c476t-8930cfcf363534ff226410a6929e1963594503284f9a6d89c8022affb19239e93</originalsourceid><addsrcrecordid>eNqFkl2L1TAQhoMo7vHoPxDpjXrVOvlo2twIsvixsOCFeh2y6URTe5Jj0i6ef2-6PbDgzUJgyOSZN8m8Q8hLCg0FKt-NjQ_jkk4NA5ANdA0I_ojsaN-pGpjsHpMdAIOa8p5fkGc5jwC0A86fkosShWoZ3xFzFdy0YLBYRVflJf3EGN7mCv8eMfm7vAlDOSjbW599DFVZCetYEmZe9yUUyM2Yql_-WLlk7Lwk3MTS6Tl54syU8cU57smPTx-_X36pr79-vrr8cF1b0cm57hUH66zjkrdcOMeYFBSMVEwhVSWpRAuc9cIpI4de2R4YM87dUMW4QsX35M2me0zxz4J51gefLU6TCRiXrDtoFW8pexCkSkglJRRQbKBNMeeETh-TP5h00hT06oEe9eaBXj3Q0OniQSl7ddZfbg443Bedm16A12fAZGum0rBgfb7n-r7nrHx5T95vHJa23XpMOts7Swaf0M56iP6hl_wvYCcffLnzN54wj3FJoViiqc5Mg_62zss6LiABRFec-Afl2buT</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>19469660</pqid></control><display><type>article</type><title>Influence of surgeon's experience and supervision on re-operation rate after hip fracture surgery</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Palm, Henrik ; Jacobsen, Steffen ; Krasheninnikoff, Michael ; Foss, Nicolai Bang ; Kehlet, Henrik ; Gebuhr, Peter</creator><creatorcontrib>Palm, Henrik ; Jacobsen, Steffen ; Krasheninnikoff, Michael ; Foss, Nicolai Bang ; Kehlet, Henrik ; Gebuhr, Peter ; The Hip Fracture Study Group ; Hip Fracture Study Group</creatorcontrib><description>Summary 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.</description><identifier>ISSN: 0020-1383</identifier><identifier>EISSN: 1879-0267</identifier><identifier>DOI: 10.1016/j.injury.2006.07.043</identifier><identifier>PMID: 17049523</identifier><identifier>CODEN: INJUBF</identifier><language>eng</language><publisher>Oxford: Elsevier Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Clinical Competence - standards ; Experience ; Female ; Femur ; Fracture ; Hip ; Hip Fractures - surgery ; Humans ; Injuries of the limb. Injuries of the spine ; Male ; Medical sciences ; Middle Aged ; Orthopedics ; Orthopedics - standards ; Prospective Studies ; Re-operation ; Recurrence ; Reoperation - statistics & numerical data ; Supervision ; Surgeon ; Traumas. Diseases due to physical agents</subject><ispartof>Injury, 2007-07, Vol.38 (7), p.775-779</ispartof><rights>Elsevier Ltd</rights><rights>2006 Elsevier Ltd</rights><rights>2007 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c476t-8930cfcf363534ff226410a6929e1963594503284f9a6d89c8022affb19239e93</citedby><cites>FETCH-LOGICAL-c476t-8930cfcf363534ff226410a6929e1963594503284f9a6d89c8022affb19239e93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0020138306004736$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18883296$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17049523$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Palm, Henrik</creatorcontrib><creatorcontrib>Jacobsen, Steffen</creatorcontrib><creatorcontrib>Krasheninnikoff, Michael</creatorcontrib><creatorcontrib>Foss, Nicolai Bang</creatorcontrib><creatorcontrib>Kehlet, Henrik</creatorcontrib><creatorcontrib>Gebuhr, Peter</creatorcontrib><creatorcontrib>The Hip Fracture Study Group</creatorcontrib><creatorcontrib>Hip Fracture Study Group</creatorcontrib><title>Influence of surgeon's experience and supervision on re-operation rate after hip fracture surgery</title><title>Injury</title><addtitle>Injury</addtitle><description>Summary 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.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Clinical Competence - standards</subject><subject>Experience</subject><subject>Female</subject><subject>Femur</subject><subject>Fracture</subject><subject>Hip</subject><subject>Hip Fractures - surgery</subject><subject>Humans</subject><subject>Injuries of the limb. Injuries of the spine</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Orthopedics</subject><subject>Orthopedics - standards</subject><subject>Prospective Studies</subject><subject>Re-operation</subject><subject>Recurrence</subject><subject>Reoperation - statistics & numerical data</subject><subject>Supervision</subject><subject>Surgeon</subject><subject>Traumas. Diseases due to physical agents</subject><issn>0020-1383</issn><issn>1879-0267</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkl2L1TAQhoMo7vHoPxDpjXrVOvlo2twIsvixsOCFeh2y6URTe5Jj0i6ef2-6PbDgzUJgyOSZN8m8Q8hLCg0FKt-NjQ_jkk4NA5ANdA0I_ojsaN-pGpjsHpMdAIOa8p5fkGc5jwC0A86fkosShWoZ3xFzFdy0YLBYRVflJf3EGN7mCv8eMfm7vAlDOSjbW599DFVZCetYEmZe9yUUyM2Yql_-WLlk7Lwk3MTS6Tl54syU8cU57smPTx-_X36pr79-vrr8cF1b0cm57hUH66zjkrdcOMeYFBSMVEwhVSWpRAuc9cIpI4de2R4YM87dUMW4QsX35M2me0zxz4J51gefLU6TCRiXrDtoFW8pexCkSkglJRRQbKBNMeeETh-TP5h00hT06oEe9eaBXj3Q0OniQSl7ddZfbg443Bedm16A12fAZGum0rBgfb7n-r7nrHx5T95vHJa23XpMOts7Swaf0M56iP6hl_wvYCcffLnzN54wj3FJoViiqc5Mg_62zss6LiABRFec-Afl2buT</recordid><startdate>20070701</startdate><enddate>20070701</enddate><creator>Palm, Henrik</creator><creator>Jacobsen, Steffen</creator><creator>Krasheninnikoff, Michael</creator><creator>Foss, Nicolai Bang</creator><creator>Kehlet, Henrik</creator><creator>Gebuhr, Peter</creator><general>Elsevier Ltd</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U1</scope><scope>7U2</scope><scope>C1K</scope><scope>7X8</scope></search><sort><creationdate>20070701</creationdate><title>Influence of surgeon's experience and supervision on re-operation rate after hip fracture surgery</title><author>Palm, Henrik ; Jacobsen, Steffen ; Krasheninnikoff, Michael ; Foss, Nicolai Bang ; Kehlet, Henrik ; Gebuhr, Peter</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c476t-8930cfcf363534ff226410a6929e1963594503284f9a6d89c8022affb19239e93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Clinical Competence - standards</topic><topic>Experience</topic><topic>Female</topic><topic>Femur</topic><topic>Fracture</topic><topic>Hip</topic><topic>Hip Fractures - surgery</topic><topic>Humans</topic><topic>Injuries of the limb. Injuries of the spine</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Orthopedics</topic><topic>Orthopedics - standards</topic><topic>Prospective Studies</topic><topic>Re-operation</topic><topic>Recurrence</topic><topic>Reoperation - statistics & numerical data</topic><topic>Supervision</topic><topic>Surgeon</topic><topic>Traumas. Diseases due to physical agents</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Palm, Henrik</creatorcontrib><creatorcontrib>Jacobsen, Steffen</creatorcontrib><creatorcontrib>Krasheninnikoff, Michael</creatorcontrib><creatorcontrib>Foss, Nicolai Bang</creatorcontrib><creatorcontrib>Kehlet, Henrik</creatorcontrib><creatorcontrib>Gebuhr, Peter</creatorcontrib><creatorcontrib>The Hip Fracture Study Group</creatorcontrib><creatorcontrib>Hip Fracture Study Group</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>Environmental Sciences and Pollution Management</collection><collection>MEDLINE - Academic</collection><jtitle>Injury</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Palm, Henrik</au><au>Jacobsen, Steffen</au><au>Krasheninnikoff, Michael</au><au>Foss, Nicolai Bang</au><au>Kehlet, Henrik</au><au>Gebuhr, Peter</au><aucorp>The Hip Fracture Study Group</aucorp><aucorp>Hip Fracture Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Influence of surgeon's experience and supervision on re-operation rate after hip fracture surgery</atitle><jtitle>Injury</jtitle><addtitle>Injury</addtitle><date>2007-07-01</date><risdate>2007</risdate><volume>38</volume><issue>7</issue><spage>775</spage><epage>779</epage><pages>775-779</pages><issn>0020-1383</issn><eissn>1879-0267</eissn><coden>INJUBF</coden><abstract>Summary 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.</abstract><cop>Oxford</cop><pub>Elsevier Ltd</pub><pmid>17049523</pmid><doi>10.1016/j.injury.2006.07.043</doi><tpages>5</tpages></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Biological and medical sciences Clinical Competence - standards Experience Female Femur Fracture Hip Hip Fractures - surgery Humans Injuries of the limb. Injuries of the spine Male Medical sciences Middle Aged Orthopedics Orthopedics - standards Prospective Studies Re-operation Recurrence Reoperation - statistics & numerical data Supervision Surgeon Traumas. Diseases due to physical agents |
| title | Influence of surgeon's experience and supervision on re-operation rate after hip fracture surgery |
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