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Older Surgeons Produce Lower Mortality Rates

By Philip Betbeze  
   April 26, 2018

A new study suggests that emergency surgeries performed by surgeons age 50 and up produce lower mortality rates than those performed by younger surgeons.

A new study in the British Medical Journal suggests older surgeons' emergency surgery patients experience lower mortality rates than patients who were operated on by younger physicians, according to researchers from UCLA and several other institutions. The study adjusted for various patient characteristics.

Though researchers did not speculate as to why mortality rates were uniformly less as surgeons' age rose, they did suggest there is a need for more oversight and supervision of surgeons in their early post-residency careers and that more research is needed.

Mortality rates were:

  • 6.6% for surgeons aged 40 and younger.
     
  • 6.5% for those 40 to 49 years old.
     
  • 6.4% for surgeons aged 50 to 59 years.
     
  • 6.3% for surgeons age 60 and older.
     
  • Mortality rates did not differ significantly depending on whether the surgeon was male or female, although female surgeons in their 50s experienced the lowest mortality rate.

Researchers examined medical records of 892,18 Medicare patients age 65 to 99 who experienced one of 20 common types of emergency surgery between 2011 and 2014. Records incorporated procedures performed by 45,826 surgeons. The study focused on surgeries, based on their emergency nature, for which patients are less likely to select their surgeons, and surgeons are less likely to select their patients, and measured mortality within 30 days of the operative procedure. 

Researchers conducted the study in large part because of debates about surgical outcomes and the age of surgeons performing them, and whether surgeons should have a formal retirement age.

Although some evidence suggests that older surgeons may have higher patient mortality than their younger peers, the data are old, both surgical training and surgical technology have changed substantially since these studies were conducted, and previous studies included elective surgeries, making it possible that older, more experienced surgeons treated more complicated patients.

The difference is likely clinically meaningful. The researchers suggest that for every 333 Medicare beneficiaries who undergo surgery, one fewer death would occur if surgical quality of care was equivalent between younger and older surgeons.

Researchers stressed that the findings may not be applicable to long-term mortality and complication rates, and that the analysis was limited to Medicare patients and may not apply to non-Medicare patients, physicians in other specialties and outpatient care.

Philip Betbeze is the senior leadership editor at HealthLeaders.


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