The impact of an anesthesia residency teaching service on anesthesia-controlled time and postsurgical patient outcomes: a retrospective observational study on 15,084 surgical cases

• Published in: Patient safety in surgery 2024-04, Vol.18 (1), p.12-12, Article 12
• Main Authors: Lynch, Davene, Mongan, Paul D, Hoefnagel, Amie L
• Format: Article
• Language: English
• Subjects: Airway management; Anaesthesia; Anesthesia; Anesthesiology; Body mass index; Care and treatment; Classification; Clinical outcomes; Comorbidity; Creatinine; Datasets; Efficiency; Extubation; Hypotension; Kidneys; Medical personnel; Medical research; Medicine, Experimental; Mortality; Multivariable control; Multivariate analysis; Observational studies; Obstetrics; Ophthalmology; Patient outcomes; Patient safety; Patients; Registered nurses; Regression models; Renal function; Review boards; Surgery; Variables
• ISSN: 1754-9493; 1754-9493
• DOI: 10.1186/s13037-024-00394-z

Limited data exists regarding the impact of anesthesia residents on operating room efficiency and patient safety outcomes. This investigation hypothesized that supervised anesthesiology residents do not increase anesthesia-controlled or prolonged extubation times compared to supervised certified registered nurse anesthetists (CRNA)/certified anesthesiologist assistants (CAA) or anesthesiologists working independently. Secondary objectives included differences in critical outcomes such as intraoperative hypotension, cardiac and pulmonary complications, acute kidney injury, and mortality. This retrospective single-center 24-month (January 1, 2020- December 31, 2021) cohort focused on primary outcomes of anesthesia-controlled times and prolonged extubation (>15 min) with additional assessment of secondary patient outcomes in adult patients having general anesthesia with an endotracheal tube or laryngeal mask airway for elective non-cardiac surgery. The study excluded sedation, obstetric, endoscopic, ophthalmology, and non-operating room procedures. Procedures were divided into three groups: anesthesiologists working solo, anesthesiologists supervising residents, or anesthesiologists supervising CRNA/CAAs. After univariate analysis, multivariable models were constructed to control for the univariate cofactor differences in the primary and secondary outcomes. A total of 15,084 surgical cases met the inclusion criteria for this study for the three different care models: solo anesthesiologists (1,204 cases), anesthesiologist/resident pairing (3,146 cases), and anesthesiologist/CRNA/CAA (14,040 cases). Before multivariate analysis, the resident group exhibited longer anesthesia-controlled times (median, [interquartile range], 26.1 [21.7-32.0], p 15 min) were significantly less common in the anesthesiologist-only group compared to the other groups (p