Surgeon’s experience level and risk of reoperation after hip fracture surgery: an observational study on 30,945 patients in the Norwegian Hip Fracture Register 2011–2015

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Hip fracture (n=30945). Intervention: Inexperienced surgeon ( 3 years' experience). Primary outcome: Reoperation (RR 1.2, 95% CI 1.1-1.4, p=0.001).

Ane L Authen; Eva Dybvik; Ove Furnes; Jan‐Erik Gjertsen

doi:10.1080/17453674.2018.1481588

June 4, 2018Acta OrthopaedicaOpen Access

Surgeon’s experience level and risk of reoperation after hip fracture surgery: an observational study on 30,945 patients in the Norwegian Hip Fracture Register 2011–2015

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Key result

Hip fracture operations performed by inexperienced surgeons with less than 3 years of experience were associated with an increased risk of reoperation compared to experienced surgeons (RR 1.2).

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Why the study?

Does surgeon's experience level affect the risk of reoperation after hip fracture surgery?

Study Design

Type

Observational (n=30,945)

Multicenter

Yes

Structured PICO

Does surgeon's experience level affect the risk of reoperation after hip fracture surgery?

P

Population

30,945 patients aged 60 years and older undergoing hip fracture surgery, followed for a median of 1.2 to 1.4 years.

E

Exposure

Surgeon's experience level

O

Outcome

Risk of reoperation after hip fracture surgeryhard clinical

Main Result

Relative Risk: 1.2 (95% CI 1.1–1.4)

Absolute Event Rate: 6.9% vs 5.6%

p-value: p=0.001

Limitations

Registration of reoperations had a lower completeness (approximately 70%), which gives an inaccurate estimation of the total risk for reoperation.
The 3-year limit for defining an experienced surgeon may not accurately reflect the actual volume of hip fracture operations a surgeon has performed.
Experienced surgeons performed a majority of the procedures, making the comparison basis unbalanced.
Lack of radiological data prevents assessment of the quality of primary operations (e.g., implant position and fracture reduction).
Inability to assess whether a reoperation was caused by a new trauma or due to failure of an osteosynthesis.
More patients with severe comorbidity and complex fractures were managed by experienced surgeons, which might have influenced the results despite adjustments.

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Cite This Study

Authen et al. (2018) conducted an observational in Hip fracture (n=30,945). Inexperienced surgeon (< 3 years' experience) vs. Experienced surgeon (> 3 years' experience) was evaluated on Reoperation (RR 1.2, 95% CI 1.1-1.4, p=0.001). Hip fracture operations performed by inexperienced surgeons with less than 3 years of experience were associated with an increased risk of reoperation compared to experienced surgeons (RR 1.2).

synapsesocial.com/papers/6a9fecd6b2b7a06144ba4f93 https://doi.org/10.1080/17453674.2018.1481588

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Surgeon’s experience level and risk of reoperation after hip fracture surgery: an observational study on 30,945 patients in the Norwegian Hip Fracture Register 2011–2015

Figures

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Abstract

Discussion

Cite This Study

Surgeon’s experience level and risk of reoperation after hip fracture surgery: an observational study on 30,945 patients in the Norwegian Hip Fracture Register 2011–2015

Figures

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Abstract

Discussion

Cite This Study

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