HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Douglas E. Wood Permission Requests Google Scholar Articles by Wood, D. E. Articles by Farjah, F. PubMed Articles by Wood, D. E. Articles by Farjah, F. Related Collections Professional affairs Related Article

---

Editorial

Surgeon Specialty Is Associated With Better Outcomes: The Facts Speak for Themselves

Division of Cardiothoracic Surgery, University of Washington, Seattle, Washington

^_* Address correspondence to Dr Wood, Division of Cardiothoracic Surgery, University of Washington, 1959 NE Pacific, Rm AA-115, Box 356310, Seattle, WA 98195-6310 (Email: dewood@u.washington.edu).

The first 300 words of the full text of this article appear below.

Any editorial written by a thoracic surgeon regarding the benefits of surgeon specialty on patient outcomes should be immediately suspect due to obvious self-interest, but enough data now exist to allow the facts to speak for themselves. In this issue of the Annals, the study by Schipper and associates [1] notes that general thoracic surgeons performed only 5% to 10% of four index thoracic operations, with more than 50% performed by general surgeons [1]. However, postoperative mortality in the four thoracic surgery procedures was 34% to 51% lower and prolonged postoperative hospitalization was 36% to 46% lower when performed by general thoracic surgeons, suggesting that 17,849 deaths and 140,754 hospital stays greater than 14 days could have been avoided during a 10-year period if thoracic surgical care were standardized in the United States (U.S.).

The authors conducted a retrospective cohort investigation using data from the National Inpatient Sample evaluating the relationship between surgeon specialty and early morbidity and mortality [1]. They evaluated four index general thoracic surgical procedures—lobectomy, sublobar resection, pneumonectomy, and decortication—and three groups of surgeons—general thoracic, cardiac, and general surgeon. Outcomes were in-hospital mortality and prolonged length of stay, a surrogate for morbidity. They found that patients under the care of general thoracic surgeons had a lower adjusted risk of early death and morbidity for each index procedure compared with general surgeons. Schipper and associates' investigation adds to a growing body of evidence that suggests that the type of surgeon caring for patients with thoracic disease has an important effect on outcome.

This study is noteworthy in that, unlike prior studies using Medicare or Surveillance, Epidemiology, and End-Results-Medicare data, it examines all adult patients, regardless of payer status. As a result, this study is more likely to be generalizable to the . . . [Full Text of this Article]

Related Article

The influence of surgeon specialty on outcomes in general thoracic surgery: a national sample 1996 to 2005.

, , , and
Ann. Thorac. Surg. 88: 1566-1573. [Full Text]