[personal profile] archerships
http://www.wate.com/global/story.asp?s=1488616&ClientType=Printable

Practice Makes Perfect for Surgeons


(Ivanhoe Newswire) -- If you need surgery to repair the largest blood vessel in your body, a new study says your risk of surviving the surgery is much higher if your surgeon has operated on many other patients with the same condition.


The study compared the mortality rates of nearly 4,000 patients who underwent surgery to repair an intact abdominal aortic aneurysm. An AAA is a weak spot in the aorta, the body's main blood vessel. When the vessel wall gets too thin and weak it can burst and cause a stroke.



Patients in the study were operated on by either a vascular, cardiac or general surgeon. Researchers found 2.2 percent of patients operated on by vascular surgeons died, compared to 4 percent of patients operated on by cardiac surgeons and 5.5 percent of patients operated on by general surgeons. The analysis shows the risk of death was 76-percent higher if a general surgeon performed the operation than if a vascular surgeon or cardiac surgeon did it.


The researchers also looked at how many AAA repairs all three types of surgeons performed each year. They qualified any surgeon, no matter what their specialty, as "high-volume" if they repaired more than 10 AAAs in a year. The study found patients operated on by "high-volume" surgeons were 40-percent less likely to die in the hospital than those operated on by "low-volume" surgeons.


Senior author Gilbert R. Upchurch, Jr., M.D., says, "The bottom line is that with a complex operation like this, experience counts."


The study's authors conclude patients have the best chance of survival if a vascular surgeon -- a surgeon who specializes in operating on blood vessels -- repairs their abdominal aortic aneurysms, or AAAs. The authors say if a vascular surgeon is not available, patients should at least try to go to a surgeon or a hospital with a high level of experience performing the tricky procedure.


Researchers also found that if patients had the surgery in a hospital that performed at least 35 AAA operations a year, they had a 30 percent lower chance of dying in the hospital.


This article was reported by Ivanhoe.com, who offers Medical Alerts by e-mail every day of the week. To subscribe, go to: http://www.ivanhoe.com/newsalert/.


SOURCE: Journal of Vascular Surgery, 2003;38:739-744

Date: 2004-07-24 06:45 pm (UTC)
From: [identity profile] herbaliser.livejournal.com
that "risk of surviving" confused me for a minute.

Date: 2004-07-24 07:04 pm (UTC)
From: [identity profile] crasch.livejournal.com
Heh. Yes, it is an odd way of phrasing it. Although I suppose it depends on how happy with your daily life.

Date: 2004-07-24 10:22 pm (UTC)
From: [identity profile] badger.livejournal.com
I agree that experience is important for complex procedures. When I had surgery (joint-related and non-life-threatening) a few years ago and the surgeon recommended a particular procedure, my first question was "Why is this the best solution to my problem?"
Second was "What options did you consider besides this, and why did you reject them?"
Third was "How many times have you performed this procedure?"
Fourth was "What's your overall success rate for this procedure?"
Fifth was "What factors in my personal medical history do you think affect the likelihood of a successful outcome relative to your personal success rate for this procedure, and in which direction(s)?"

Since he had coherent and rational-sounding answers for the first five, my sixth was "When can we schedule this?" :)