August 29, 2006

Surgeons’ experience counts as much as age

By Charnicia Huggins

NEW YORK -- Contrary to what some may think, having a surgical procedure performed by a relatively young surgeon may not be any more risky than having it performed by an older surgeon.

In fact, for certain procedures, some older surgeons have higher operative death rates than do younger surgeons, new study findings indicate.

"Surgeon age, young or old, should not be a primary factor when patients are making a choice for a surgeon," study co-author Dr. Jennifer F. Waljee, of the University of Michigan, told Reuters Health.

Instead, people facing an operation "should consider other factors, such as procedural volume, specialization, practice setting, and reputation when making their choices for providers," she added.

Waljee and her co-investigators analyzed national Medicare data to determine rates of operative mortality among nearly 461,000 patients who underwent one of eight different surgical procedures between 1998 and 1999. Operative mortality was defined as death that occurred either before a patient was discharged from the hospital or within a month of the surgical procedure.

The team used statistical techniques to determine the relationship between surgeon age -- 40 years and younger, 41 to 50 years, 51 to 60 years, and over 60 years -- and operative mortality.

Overall, surgeons above the age of 60 years had slightly higher death rates with certain complicated heart- and cancer-related procedures than did those aged 41 to 50 years, Waljee and her team report in the Annals of Surgery.

These increased death rates were evident only among surgeons who performed comparatively few of the procedures, however, and were not associated with mortality rates for other surgeries, the researchers note.

"For some complex procedures, surgeons older than 60 years, particularly those with low procedure volumes, have higher operative mortality rates than their younger counterparts," they write.

What's more, surgeons aged 40 years and younger had rates of operative mortality comparable to that found among those aged 41 to 50 years for all eight surgical procedures examined, study findings indicate.

"Our results are encouraging in that for the majority of operations, the age of the surgeon you choose is not associated with your overall risk of mortality," Waljee told Reuters Health.

"For the few where older surgeon age did confer a higher risk of mortality, the overall magnitude was small, and was limited to those surgeons with lower procedure volumes," Waljee concluded.

SOURCE: Annals of Surgery, September 2006.