MAY 08, 2018

Are Older Surgeons Better Than Their Younger Counterparts?

WRITTEN BY: Brenda Kelley Kim

Younger isn't always better and older isn't always a bad thing, at least regarding surgical experience. Patients who undergo emergency surgery have a lower risk of dying if their surgeon is over 60. That's the result of a study published recently by a team at UCLA. The work investigated whether age or gender could be correlated with patient outcomes.

The study was observational, so it's not possible to say that being younger or older will cause fewer deaths, but the data did show that experience matters. Records from Medicare patients aged 65-99 years who underwent one of 20 major emergency surgical procedures at US acute care hospitals between 2011 and 2014 were analyzed to find the incidence of post-surgical deaths. They defined surgical mortality as a death that occurred during surgery or within 30 days after an operation. A total of 892,187 patients were treated by 45,826 surgeons with an overall operative mortality rate of 6.4% (56,803). While the mortality rates were lower for older surgeons, it wasn't by much. Still, the researchers posited that if the relationship between age and mortality were causal, there would be one less death for older surgeons for every 333 patients.

There was some number crunching to be done to come up with the results. After adjusting for the age range of patients, surgeon and hospital features that could impact the results and other factors the compared death rates to the age and gender of surgeons. The researchers found that patient mortality was slightly lower for older surgeons than for younger surgeons within the same hospital but did not differ meaningfully between male and female surgeons.

When the data were combined by both age and gender, it showed the lowest mortality rate was for female surgeons in their 50s. Previous research has indicated the opposite with worse outcomes for patients treated by older physicians, but it was chalked up to newer practice methods older doctors did not use. The latest research indicates that even doctors who have decades of experience can still match the cutting edge skills of their younger colleagues.

The team summarized their findings, writing, "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." The video included has more information, take a look.

Sources: EurekAlert, British Medical Journal UPI