Lower death rates among older surgeons

PATIENTS undergoing emergency surgery had slightly lower death rates when operated on by older surgeons compared to younger ones, a new US study suggests.

Surgeons aged 60 and over had lower operative mortality (defined as death during hospital admission or within 30 days of the procedure) compared to those under 40. And while there was no evidence that mortality rates differed between the sexes, female surgeons in their 50s had the lowest death rates.

The study by UCLA in California, and published in the BMJ, analysed data on almost 900,000 patients in the US who underwent one of 20 major non-elective surgeries between 2011 and 2014.

If the results are causal then, the researchers suggest that one out of every 333 patients could be saved if care was the same between younger and older surgeons.

Previously, research had indicated worse outcomes among patients treated by older hospital doctors. This is often attributed to practice changes since training, and possibly poor adherence to guidelines.

The researchers stated: “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.”

They concluded: "Our finding that younger surgeons have higher mortality suggests that more oversight and supervision early in a surgeon’s career may be useful and at least warrants further investigation.

“Equivalent outcomes between male and female surgeons suggest that patients undergoing surgery receive high-quality care irrespective of surgeon sex.”