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The Influence of Surgeon Sex on Adverse Events Following Primary Total Hip Arthroplasty : A Register-Based Study of 11,993 Procedures and 200 Surgeons in Swedish Public Hospitals

Jolbäck, Per ; Rogmark, Cecilia LU ; Bedeschi Rego De Mattos, Camila LU orcid ; Chen, Antonia F ; Nauclér, Emma and Tsikandylakis, Georgios (2022) In The Journal of bone and joint surgery. American volume 104(15). p.1327-1333
Abstract

BACKGROUND: Stereotypes may prevail, but little is known about the influence that the sex of an orthopaedic surgeon may have on outcomes. In a recently published study, there were no differences in the rate of adverse events following total hip arthroplasties (THAs) performed by female or male orthopaedic surgeons. The objective of the present study was to investigate whether there was any difference in adverse events within 90 days following a primary THA performed by either a male or female surgeon in Sweden.

METHODS: A retrospective study was performed to evaluate primary THAs performed for osteoarthritis between 2008 and 2016 at 10 hospitals in western Sweden. Local hospital data were linked with the Swedish Hip Arthroplasty... (More)

BACKGROUND: Stereotypes may prevail, but little is known about the influence that the sex of an orthopaedic surgeon may have on outcomes. In a recently published study, there were no differences in the rate of adverse events following total hip arthroplasties (THAs) performed by female or male orthopaedic surgeons. The objective of the present study was to investigate whether there was any difference in adverse events within 90 days following a primary THA performed by either a male or female surgeon in Sweden.

METHODS: A retrospective study was performed to evaluate primary THAs performed for osteoarthritis between 2008 and 2016 at 10 hospitals in western Sweden. Local hospital data were linked with the Swedish Hip Arthroplasty Register (SHAR) and with a regional patient register. Data collected from local hospitals and the SHAR included surgeon-related information (e.g., sex, annual volume, and level of training) and patient-related information (e.g., age, sex, and Elixhauser comorbidity index). Adverse events were retrieved from the regional patient register. The definition of adverse events followed the SHAR definition of adverse events. Mixed models were used to investigate the impact of surgeon sex on adverse events.

RESULTS: A total of 11,993 primary THAs were performed by 200 surgeons, of whom 17.5% were women. The proportions of adverse events within 90 days were similar for female (6%) and male (7%) surgeons. No association was found between surgeon sex and adverse events (adjusted odds ratio, 0.72; 95% confidence interval, 0.52 to 1.00) when all surgeons (both attendings and residents) were included in the analysis. A sensitivity analysis that included attendings only yielded similar results (adjusted odds ratio, 0.88; 95% confidence interval, 0.60 to 1.29).

CONCLUSIONS: Despite a small tendency toward lower rates of adverse events at 90 days after THAs performed by female surgeons, there was no significant association between surgeon sex and the risk of adverse events following THA.

LEVEL OF EVIDENCE: Therapeutic Level III . See Instructions for Authors for a complete description of levels of evidence.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Arthroplasty, Replacement, Hip/methods, Female, Hospitals, Public, Humans, Male, Retrospective Studies, Surgeons, Sweden/epidemiology, Treatment Outcome
in
The Journal of bone and joint surgery. American volume
volume
104
issue
15
pages
1327 - 1333
publisher
Lippincott Williams & Wilkins
external identifiers
  • scopus:85135598744
  • pmid:35867715
ISSN
1535-1386
DOI
10.2106/JBJS.21.00744
language
English
LU publication?
yes
additional info
Copyright © 2022 by The Journal of Bone and Joint Surgery, Incorporated.
id
f5bd9280-c12e-493e-8c06-ea40af6d62fb
date added to LUP
2023-11-16 09:31:22
date last changed
2024-04-14 16:54:33
@article{f5bd9280-c12e-493e-8c06-ea40af6d62fb,
  abstract     = {{<p>BACKGROUND: Stereotypes may prevail, but little is known about the influence that the sex of an orthopaedic surgeon may have on outcomes. In a recently published study, there were no differences in the rate of adverse events following total hip arthroplasties (THAs) performed by female or male orthopaedic surgeons. The objective of the present study was to investigate whether there was any difference in adverse events within 90 days following a primary THA performed by either a male or female surgeon in Sweden.</p><p>METHODS: A retrospective study was performed to evaluate primary THAs performed for osteoarthritis between 2008 and 2016 at 10 hospitals in western Sweden. Local hospital data were linked with the Swedish Hip Arthroplasty Register (SHAR) and with a regional patient register. Data collected from local hospitals and the SHAR included surgeon-related information (e.g., sex, annual volume, and level of training) and patient-related information (e.g., age, sex, and Elixhauser comorbidity index). Adverse events were retrieved from the regional patient register. The definition of adverse events followed the SHAR definition of adverse events. Mixed models were used to investigate the impact of surgeon sex on adverse events.</p><p>RESULTS: A total of 11,993 primary THAs were performed by 200 surgeons, of whom 17.5% were women. The proportions of adverse events within 90 days were similar for female (6%) and male (7%) surgeons. No association was found between surgeon sex and adverse events (adjusted odds ratio, 0.72; 95% confidence interval, 0.52 to 1.00) when all surgeons (both attendings and residents) were included in the analysis. A sensitivity analysis that included attendings only yielded similar results (adjusted odds ratio, 0.88; 95% confidence interval, 0.60 to 1.29).</p><p>CONCLUSIONS: Despite a small tendency toward lower rates of adverse events at 90 days after THAs performed by female surgeons, there was no significant association between surgeon sex and the risk of adverse events following THA.</p><p>LEVEL OF EVIDENCE: Therapeutic Level III . See Instructions for Authors for a complete description of levels of evidence.</p>}},
  author       = {{Jolbäck, Per and Rogmark, Cecilia and Bedeschi Rego De Mattos, Camila and Chen, Antonia F and Nauclér, Emma and Tsikandylakis, Georgios}},
  issn         = {{1535-1386}},
  keywords     = {{Arthroplasty, Replacement, Hip/methods; Female; Hospitals, Public; Humans; Male; Retrospective Studies; Surgeons; Sweden/epidemiology; Treatment Outcome}},
  language     = {{eng}},
  month        = {{08}},
  number       = {{15}},
  pages        = {{1327--1333}},
  publisher    = {{Lippincott Williams & Wilkins}},
  series       = {{The Journal of bone and joint surgery. American volume}},
  title        = {{The Influence of Surgeon Sex on Adverse Events Following Primary Total Hip Arthroplasty : A Register-Based Study of 11,993 Procedures and 200 Surgeons in Swedish Public Hospitals}},
  url          = {{http://dx.doi.org/10.2106/JBJS.21.00744}},
  doi          = {{10.2106/JBJS.21.00744}},
  volume       = {{104}},
  year         = {{2022}},
}