Journal of Surgical Research最新文献

{"title":"Association Between Inadequate Pain Control and Emergency Department Utilization in Trauma Patients","authors":"Sophia M. Smith MD, MS ,&nbsp;Rachel Adams PA-C ,&nbsp;Emily J. Ha BS ,&nbsp;Wang Pong Chan BS, BA ,&nbsp;Kendall Jenkins MD ,&nbsp;Cara Michael BA ,&nbsp;Noelle N. Saillant MD ,&nbsp;Jeffrey A. Franks MSPH ,&nbsp;Sabrina E. Sanchez MD, MPH","doi":"10.1016/j.jss.2025.04.033","DOIUrl":"10.1016/j.jss.2025.04.033","url":null,"abstract":"<div><h3>Introduction</h3><div>Up to 20% of trauma patients return to the emergency department (ED) within 30 d, most commonly for pain. The association between inpatient opioids, discharge prescriptions, and ED visits has not been studied.</div></div><div><h3>Materials and methods</h3><div>This is a single-institution, retrospective nested case-control study of adult trauma patients admitted to an urban level I trauma center, 2018-2021, with an opioid requirement at discharge. Multivariable logistic regression was used to determine the association between discharge opioid prescriptions, days of pain control prescribed based on individual patient needs, and ED visits for pain.</div></div><div><h3>Results</h3><div>Of 1569 patients, 1173 (74.76%) were prescribed opioids at discharge, and 167 (10.64%) had an ED visit for pain. Those discharged with an opioid prescription had lower odds of ED visits for pain (odds ratio 0.66, 95% confidence interval 0.44-0.99, <em>P</em> = 0.04). The median days of pain control prescribed at discharge was 0.61 (interquartile range 0-2.22) for those with an ED visit, compared to 1.5 (interquartile range 0.10-3.75) for those without. However, discharge with greater pain control days was not significantly associated the odds of ED visits for uncontrolled pain (odds ratio 0.96, 95% confidence interval 0.91-1.02, <em>P</em> = 0.19).</div></div><div><h3>Conclusions</h3><div>Among patients requiring opioids at discharge, lack of discharge opioid prescriptions is associated with increased odds of ED visits for pain. For those patients who are prescribed opioids, quantity is not significant, indicating that a conservative approach may be appropriate. Providers should consider careful analysis of inpatient pain control prescriptions, appropriate tapers, and ensure commensurate prescriptions at discharge to optimize pain management and potentially reduce preventable ED visits.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"311 ","pages":"Pages 241-249"},"PeriodicalIF":1.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144147977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Predictive Value of Basic Laparoscopic Evaluations on Complex Cases Using the Society for Improving Medical Procedural Learning Database","authors":"Jeremy A. Balch MD ,&nbsp;Stefanie S. Sebok-Syer PhD ,&nbsp;Kayla Marcotte MS ,&nbsp;Alyssa A. Pradarelli MD ,&nbsp;Rebecca Moreci MD ,&nbsp;Benjamin Shickel PhD ,&nbsp;Andrew E. Krumm PhD ,&nbsp;Tyler J. Loftus MD, PhD","doi":"10.1016/j.jss.2025.04.041","DOIUrl":"10.1016/j.jss.2025.04.041","url":null,"abstract":"<div><h3>Introduction</h3><div>The transference of technical skills from basic to complex procedures is assumed–but untested–during training and board certification. We examine whether resident performance on frequently performed, basic laparoscopic procedures can predict performance on their first complex laparoscopic procedure.</div></div><div><h3>Methods</h3><div>This cross-sectional, retrospective study employs the Society for Improving Medical Procedural Learning collaborative operating room database from 2016 to 2023 using attending-level evaluations of general surgery residents at accredited teaching hospitals. Using cumulative instances of prior basic laparoscopic procedures, we applied five machine learning algorithms to predict the performance on the resident's first complex procedure. Procedures were labeled “basic” or “complex” according to Accreditation Council on Graduate Medical Education definitions.</div></div><div><h3>Results</h3><div>7792 attending evaluations of 899 unique residents were included. The number of residents with evaluations of prior basic procedures varied and dropped linearly from 646 (2 prior) to 180 (10 prior). The best performing random forest model obtained a mean squared error of 0.23 (95% confidence interval 0.17-0.29) using 3 prior procedures. Resident postgraduate year was the most important predictor, and simple univariate regression on this variable yielded a mean squared error of 0.33 (95% confidence interval 0.31-0.37).</div></div><div><h3>Conclusions</h3><div>Basic laparoscopic performance ratings were moderately effective in predicting subsequent performance on complex procedures but offered little additional predictive value over postgraduate year alone.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"311 ","pages":"Pages 164-171"},"PeriodicalIF":1.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144138261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends, Perception, and Variation in Operative Dictation Practices Among General Surgery Residents and Its Implications on Resident's Performance and Care Efficiency: Toward Improving the Educational and Training Experience of Trainees","authors":"Brevin O'Connor BS ,&nbsp;Logan Rogers BS ,&nbsp;Andrew Ford BS ,&nbsp;Jacob Gowan MD ,&nbsp;Joseph Vanwart MD ,&nbsp;William S. Havron MD, FACS ,&nbsp;Adel Elkbuli MD, MPH, MBA","doi":"10.1016/j.jss.2025.04.032","DOIUrl":"10.1016/j.jss.2025.04.032","url":null,"abstract":"<div><h3>Introducstion</h3><div>Operative dictation is critical for accurate surgical documentation, impacting patient care, medico-legal standards, and education; however, lacking structured training causes gaps in quality and standardization. This study aims to examine the current trends and variations in dictation practices among junior (postgraduate year (PGY-1) and PGY-2) and senior (PGY-3 to PGY-5) general surgery residents.</div></div><div><h3>Methods</h3><div>A cross-sectional anonymous survey of junior and senior general surgery residents was conducted to explore dictation practices, preferences, and educational needs. The survey addressed demographics, dictation methods, mentorship, and perceptions of junior and senior residents.</div></div><div><h3>Results</h3><div>67.2% of respondents reported dictating cases, with seniors more likely to dictate both major and minor cases (75%) compared to juniors (58.6%). Oral dictation was preferred by most residents, with 58.6% of juniors using transcription-based methods and 46.9% of seniors using voice recognition. Dictation improved operative step retention for 58.6% of juniors and 62.5% of seniors, enhancing preparedness for repeated operations. Formal mentorship was reported by 58.6% of juniors but only 43.8% of seniors, while formal orientation was not available to any juniors or seniors in this study. Early formal education in dictation was supported by 75.0% of juniors and 62.5% of seniors.</div></div><div><h3>Conclusions</h3><div>This study highlights the need for structured education in operative dictation, particularly for junior residents, to improve documentation quality and preparedness. The findings emphasize the critical gap in mentorship and formalized training, with a lack of formal orientation and inconsistent mentorship opportunities posing significant barriers to skill development.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"311 ","pages":"Pages 151-157"},"PeriodicalIF":1.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144138349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-Hospital Postoperative Glycemic Trends After Pancreatic Insulinoma Resection","authors":"Sarah Lund MD ,&nbsp;Sergio Navarro MD, MBA ,&nbsp;Adrian Vella MD ,&nbsp;Benzon Dy MD ,&nbsp;Trenton Foster MD ,&nbsp;Melanie L. Lyden MD ,&nbsp;Pankaj Shah MD ,&nbsp;Travis McKenzie MD","doi":"10.1016/j.jss.2025.04.046","DOIUrl":"10.1016/j.jss.2025.04.046","url":null,"abstract":"<div><h3>Introduction</h3><div>Following resection of insulinoma, patients may develop postoperative hyperglycemia in the hospital. Predictors and trends of hyperglycemia immediately following surgery are poorly understood.</div></div><div><h3>Methods</h3><div>We conducted a single-center retrospective study of patients who underwent distal pancreatectomy, enucleation, or ethanol ablation for solitary benign pancreatic insulinoma from 2010 to 2023. In-hospital postoperative glucose trends and predictors of hyperglycemia normalization after surgery were analyzed.</div></div><div><h3>Results</h3><div>We identified 117 patients: 51% distal pancreatectomies, 42% enucleations, and 7% operative ethanol ablations. During their hospitalization, 73% of patients developed hyperglycemia postoperatively that normalized prior to discharge, while 24% had persistent hyperglycemia until discharge and 3% were normoglycemic. Of patients with glucose normalization, median time to normalization was 35 h (interquartile range= [16.3, 81.8]). Patients with glucose normalization within 5 days of surgery had significantly smaller insulinomas (median = 1.5 cm) than those without (median = 1.8 cm, <em>P</em> = 0.02). Predictors of glucose normalization within 5 days of surgery included smaller tumor size (odds ratio = 0.47, 95% confidence interval = [0.21, 0.93]; <em>P</em> = 0.05) and younger age (odds ratio = 0.97, 95% confidence interval = [0.94, 0.99], <em>P</em> = 0.04). Older age (B = 1.2, <em>P</em> = 0.02) and male gender (B = 44.7, <em>P</em> = 0.02) were associated with prolonged time to glucose normalization.</div></div><div><h3>Conclusions</h3><div>Most patients develop transient hyperglycemia immediately after insulinoma resection which resolves, on average, within 35 h of surgery. Smaller tumor size is associated with glucose normalization while older age is associated with prolonged hyperglycemia in the early postoperative period. These findings may enable both patients and surgeons to better anticipate in-hospital glucose trends after surgical management of benign insulinoma.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"311 ","pages":"Pages 158-163"},"PeriodicalIF":1.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144138260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Higher All-Cause but Not Aortic-Related Mortality for Women After Abdominal Aortic Aneurysm Repair","authors":"Yetzali Claudio Medina BS,&nbsp;Houssam Farres MD,&nbsp;Hennessy Morales Arroyo BS, MS,&nbsp;Camilo Polania Sandoval MD,&nbsp;Christopher Jacobs MD,&nbsp;Camila Esquetini Vernon MD,&nbsp;Jonathan Vandenberg MD,&nbsp;Young Erben MD","doi":"10.1016/j.jss.2025.04.030","DOIUrl":"10.1016/j.jss.2025.04.030","url":null,"abstract":"<div><h3>Introduction</h3><div>Sex-based disparities have been consistently reported after abdominal aortic aneurysm (AAA) repair. This single-center study aimed to identify whether this is a reproducible finding within our institution's cohort following AAA repair.</div></div><div><h3>Methods</h3><div>This is a single-center retrospective cohort study of patients with AAA who underwent surgical repair (open or endovascular) between 2014 and 2024. Primary outcomes were aortic-related complications at 30 d and mid-term follow-up. Secondary outcomes included reintervention and mortality. Propensity score matching based on age and procedure type was used to assess differences between sexes.</div></div><div><h3>Results</h3><div>A total of 152 patients were identified with 38 (25%) females. One hundred twelve (73.7%) patients underwent endovascular aneurysm repair, 20 (13.2%) fenestrated endovascular aneurysm repair, and 20 (13.2%) open aortic repairs. Female patients were found to be more hypertensive compared to male patients (females: 92.5%, males: 77.5%; <em>P</em> &lt; 0.01). There were no differences in terms of aortic-related complications among sexes at 30 d (males: 1.8%, females: 2.6%; <em>P</em> = 1) and reinterventions (males: 1.8%, females: 2.6%; <em>P</em> = 1). At a mean follow-up of 2.6 ± 2.3 y, no difference was found between males and females regarding aortic-related complications (males: 13.2%, females: 13.2%; <em>P</em> = 1) or reinterventions (males: 12.3%, females: 7.9%; <em>P</em> = 0.56). All-cause mortality on follow-up was recorded in 20 (17.5%) of our male and 13 (34.2%) of our female patients (<em>P</em> = 0.031), with neoplastic and cardiac causes being the most common. Vascular-related mortality was not different between male and female patients (males: 0.9%, females: 2.6%; <em>P</em> = 0.44), with one death in each group.</div></div><div><h3>Conclusions</h3><div>While aortic-related complications and reinterventions did not differ between sexes, females had higher all-cause mortality during follow-up, driven by nonaortic causes. Therefore, an individualized sex-specific approach to patients with aortic disease should be the cornerstone for decision-making regarding intervention.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"311 ","pages":"Pages 172-180"},"PeriodicalIF":1.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144138262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discrete Increases in Length of Stay by Complication After Cardiac Surgery: Analysis of 29,544 Cases","authors":"Micaella R. Zubkov MD ,&nbsp;Christina M. Stuart MD ,&nbsp;Michael R. Bronsert PhD, MS ,&nbsp;Yaxu Zhuang PhD ,&nbsp;Yi Su MS ,&nbsp;William G. Henderson PhD, MPH ,&nbsp;Joseph C. Cleveland Jr. MD ,&nbsp;Robert A. Meguid MD, MPH","doi":"10.1016/j.jss.2025.03.065","DOIUrl":"10.1016/j.jss.2025.03.065","url":null,"abstract":"<div><h3>Introduction</h3><div>Postcardiac surgery complications prolong length of stay (LOS). However, each complication's individual impact on LOS as a continuous variable has not been studied. The purpose of this study was to determine the risk-adjusted increase in LOS associated with individual postoperative complications following cardiac surgery.</div></div><div><h3>Methods</h3><div>All coronary artery bypass and grafting (CABG)-only, CABG + valve, and valve-only patients in the American College of Surgeons National Surgical Quality Improvement Program participant use file, 2005-2018 were evaluated. A negative-binomial model adjusting for the effect of preoperative characteristics and 18 postoperative complications was used to generate incidence rate ratios. This model was used to estimate risk-adjusted increases in LOS for each complication.</div></div><div><h3>Results</h3><div>Of 29,544 patients, 18,184 (61.6%) were CABG only, 8304 (28.1%) were valve only, and 3056 (10.3%) were CABG + valve, with a median LOS of 6.9 d. The most frequent complications were bleeding requiring transfusion (49.2%), prolonged ventilation (6.0%), and pneumonia (4.1%). Infectious complications, including deep surgical site infection (+18.9 d), postoperative septic shock (+17.2 d), organ space infection (+16.7), and wound dehiscence (+15.9), were associated with the largest increases in LOS, followed by respiratory complications, including unplanned reintubation (+12.5) and prolonged ventilation (+10.9). Bleeding or postoperative transfusion (+0.6) had the least effect on extending LOS.</div></div><div><h3>Conclusions</h3><div>After risk adjustment for preoperative patient characteristics and other postoperative complications, all postcardiac surgery complications except myocardial infarction were associated with prolonged LOS, ranging from +0.6 d with bleeding requiring transfusion to +18.9 d with deep surgical site infection. The results of this study provide useful evidence for quality improvement initiatives and informing patients and providers on the expected duration of hospital stay following cardiac surgery with and without complications.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"311 ","pages":"Pages 181-195"},"PeriodicalIF":1.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144138259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling the Silent Threat: Disparities in Adrenal Incidentaloma Management","authors":"John P. O'Connor BS ,&nbsp;Alekya Poloju MD ,&nbsp;Samantha K. Pabich MD ,&nbsp;Betty Allen MD ,&nbsp;Rebecca Sippel MD ,&nbsp;Amy Kind MD, PhD ,&nbsp;Alexander Chiu MD, MPH","doi":"10.1016/j.jss.2025.04.031","DOIUrl":"10.1016/j.jss.2025.04.031","url":null,"abstract":"<div><h3>Introduction</h3><div>Adrenal incidentalomas are increasingly detected, yet infrequently evaluated for hormonal excess. We investigated if patient neighborhood disadvantage is associated with the rate of workup of adrenal nodules.</div></div><div><h3>Methods</h3><div>We performed a retrospective analysis of chest and abdomen CT scans between January 1, 2021, and January 6, 2022, at a single tertiary care center in adults with an incidentally found adrenal mass. Chart review was conducted to categorize patients’ neighborhood disadvantage utilizing the Area Deprivation Index and evaluate for biochemical workup. Multivariate logistic regression was performed to determine factors associated with adrenal mass evaluation. A secondary chart review was conducted to ascertain reasons for incomplete adrenal nodule workup among disadvantaged patients.</div></div><div><h3>Results</h3><div>Among 245 included patients, most (71%) had no biochemical workup and only 11% received a guideline-concordant full evaluation. Patients living in disadvantaged neighborhoods were less likely to receive biochemical workup compared to patients in advantaged neighborhoods (odds ratio 0.51, 95% confidence interval 0.26-0.98). Additionally, scans ordered by primary care providers were associated with greater evaluation rates compared to emergency medicine providers (odds ratio 4.08, confidence interval 1.69-9.81). We identified three issues potentially contributing to low workup rates: radiologists recommended no further workup, primary care providers did not order additional tests, and patients were lost to follow-up.</div></div><div><h3>Conclusions</h3><div>The rate of guideline-based biochemical workup of adrenal incidentalomas was low at 11%, and over 70% had no evaluation at all. Patients from disadvantaged neighborhoods were significantly less likely to receive workup, as were patients seen through the emergency department.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"311 ","pages":"Pages 143-150"},"PeriodicalIF":1.8,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144134984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"Weight-Based Dosing for Venous Thromboembolism Prophylaxis in Spinal Trauma Patients Appears Safe\" [Journal of Surgical Research 2023 Volume 290, October 2023, Pages 209-214].","authors":"Thomas Heye, Tarendeep Thind, Allison Jenkins, Rebecca Reif, Hanna K Jensen, Kevin Sexton, Kyle Kalkwarf, Avi Bhavaraju","doi":"10.1016/j.jss.2025.04.016","DOIUrl":"https://doi.org/10.1016/j.jss.2025.04.016","url":null,"abstract":"","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burn Injury and Long-Term Opioid Use","authors":"Victoria R. Hammond MD, MSt,&nbsp;David D. Keeven MD,&nbsp;Jonathan C. Vacek MD,&nbsp;Matthew C. Bozeman MD,&nbsp;Keith R. Miller MD,&nbsp;Matthew V. Benns MD","doi":"10.1016/j.jss.2025.04.025","DOIUrl":"10.1016/j.jss.2025.04.025","url":null,"abstract":"<div><h3>Introduction</h3><div>Exposure to opioids is a known risk factor for long-term use and dependence. The purpose of this study was to determine the prevalence of long-term prescription opioid use among burn patients after hospitalization and to identify any risk factors for long-term dependence.</div></div><div><h3>Methods</h3><div>All patients admitted to a burn center during a single year period (2/1/2020-2/1/21) were examined. Deaths were excluded. A controlled substance reporting system was utilized to determine prescription opioid use from 6 mos prior to 12 mos post discharge. The duration of opioid use was examined. Long-term use was defined as active opioid prescription at 12 mos post discharge.</div></div><div><h3>Results</h3><div>A total of 184 patients were included in the study. A total of 54.7% of patients received an opioid prescription at discharge. Seventeen patients (9.2%) had persistent opioid use at 1 year. The only independent risk factor identified for long-term opioid use was preinjury use (<em>P</em> &lt; 0.001). Among the 17 patients on opioids at 1 year, 16 had filled three or more opioid prescriptions in the 6 mos prior to injury. The only patient with long-term opioid use without a pre-existing opioid history had multiple readmissions and delayed operative interventions after their initial hospital course.</div></div><div><h3>Conclusions</h3><div>A majority of burn patients received opioids for pain control following hospital discharge. However, the duration of therapy was generally short among opioid-naive patients. Burn injury was not associated with long-term prescription opioid use among opioid-naive patients.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"311 ","pages":"Pages 106-111"},"PeriodicalIF":1.8,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144125299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender Disparities in Career Longevity Among Surgeons and Physicians: A Decade-Long Analysis","authors":"Christina S. Boutros DO ,&nbsp;Erik L. Risa MD ,&nbsp;Omkar S. Pawar BDS, MS ,&nbsp;Aria Bassiri MD ,&nbsp;John B. Ammori MD ,&nbsp;Julie Freischlag MD ,&nbsp;Philip A. Linden MD ,&nbsp;Christopher W. Towe MD","doi":"10.1016/j.jss.2025.04.027","DOIUrl":"10.1016/j.jss.2025.04.027","url":null,"abstract":"<div><h3>Introduction</h3><div>Physician and surgeon retirement patterns are influenced by gender, specialty, and practice settings, impacting workforce composition and equity. We hypothesize that male surgeons have longer career durations and are less likely to retire than their female counterparts, with differences across specialties.</div></div><div><h3>Methods</h3><div>Data from the Center for Medicare &amp; Medicaid Services National Downloadable Database (2014-2024) were analyzed to determine career duration and retirement status among physicians and surgeons across various subspecialties. Career duration was defined as the most recent year a physician appeared in the database minus their graduation year; retirement was defined as the year their National Provider Identifier number was no longer present. Univariable and multivariable logistic regression analyzed demographic variables, practice settings, and trends, with an interaction analysis assessing the odds of retirement by specialty and gender.</div></div><div><h3>Results</h3><div>Among 280,727 physicians, retirement rates were 33.8% for females and 33.7% for males (<em>P</em> = 0.69). Female physicians had shorter careers than males (30 [25-36] versus 35 [28-42] years, <em>P</em> &lt; 0.001). Among surgeons, fewer females were retired (29.6% versus 32.6%, <em>P</em> &lt; 0.001), but males had longer careers (41 [34-47] versus 30 [24 - 38] years, <em>P</em> &lt; 0.001). Male surgeons were more likely to remain in the workforce in 2024 (odds ratio 1.5, confidence interval 1.34-1.60). Female cardiac, general, orthopedic, urologic, and plastic surgeons had lower odds of remaining in the work force compared to male general surgeons.</div></div><div><h3>Conclusions</h3><div>Male surgeons exhibit longer careers and greater workforce retention than females. Gender disparities across surgical specialties emphasize the need to support female surgeons’ career longevity and address workforce inequities.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"311 ","pages":"Pages 127-136"},"PeriodicalIF":1.8,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}