Blood, sweat, toil, and tears of surgical training. Part I: Blood.
There may be conflict between the requirements of surgical training and those of the clinical service if training has an impact on clinical outcomes. One area of potential impact is perioperative blood loss. We compared total and 12-hour blood loss after 2,079 consecutive cardiac operations performed over 2 years by trainees and consultants. One- and two-way analyses of variance with EuroSCORE and surgeon status as factors were carried out to evaluate the impact of surgeon status on blood loss. There was no difference in blood loss between consultants and trainees. We also compared the rates between consultants and trainees of patients returning to the operating room due to bleeding. This showed a significant difference, with trainees having a higher rate of investigation for bleeding. Cardiac surgical training can be achieved without an adverse effect on blood loss, but it may be associated with a higher rate of re-intervention for bleeding.
Department of Surgery, Papworth Hospital, Cambridge CB3 8RE, United Kingdom. andrewdrain@doctors.org.uk
Andrew J
AJ
Drain
Jonathon I
JI
Ferguson
Sharon
S
Wilkinson
Samer A M
SA
Nashef
D016063:Blood Loss, Surgical; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000193:education*; D002983:Clinical Competence; D003253:Consultants; D004503:Education, Medical, Graduate; D006801:Humans; D007396:Internship and Residency; D019106:Postoperative Hemorrhage / Q000209:etiology* / Q000601:surgery; D011446:Prospective Studies; D011787:Quality of Health Care; D012086:Reoperation; D018570:Risk Assessment; D016896:Treatment Outcome