Association of increasing surgeon age with decreasing in-hospital mortality after coronary artery bypass graft surgery.

Abstract

The aim of this study was to investigate the relation between surgeon age and in-hospital mortality for patients who underwent a coronary artery bypass graft (CABG) using a nationwide population-based data set. This study used data from the 2004 Taiwan National Health Insurance Research Database. The study sample comprised 3766 patients hospitalized for CABG surgery and was divided into three equal-sized surgeon age groups: <40, 40 to 45, and >45 years. A conditional (fixed-effect) logistic regression was performed to examine the relation between surgeon age and in-hospital mortality after adjusting for surgeon CABG caseload and characteristics of patients and surgeons as well as the clustering effect among surgeons. Patients who underwent CABG performed by surgeons in the <40 years age group had significantly higher in-hospital mortality rates (5.4%) than those operated on by surgeons in the 40- to 45-year age group (3.5%) and surgeons in the >45-year age group (2.6%). Regression shows that the adjusted odds ratio of in-hospital mortality for patients operated on by surgeons in the <40-year age group was 1.47 (p < 0.05) times that for surgeons in the 40- to 45-year age group and 1.82 (p < 0.05) times that for surgeons in the >45-year age group. We conclude that older surgeons are more likely to achieve better clinical performance with CABG surgery because of their greater clinical experience.