UMHS study finds surgery safer at teaching hospitals

ANN ARBOR, Mich. Having a less experienced surgical resident or even a medical student involved in complex surgical procedures may cause some patients to feel uneasy.

But a new study by University of Michigan Health System researchers has found patients undergoing complex gastrointestinal surgery at teaching hospitals are less likely to die or experience complications than those patients at non-teaching hospitals, primarily because teaching hospitals tend to perform these surgeries more often.

The study, published this month in the Archives of Surgery, looked at 6,685 people who underwent surgery in 1996 or 1997 to remove part or all of their esophagus, pancreas or liver. The researchers compared death rates and length of hospital stay for teaching hospitals with those from non-teaching hospitals by looking at patient data from 1996 and 1997 from the Nationwide Inpatient Sample, which tracks 20 percent of all hospital discharges in the United States.

Death rates overall for all three procedures were under 10 percent. But patients undergoing pancreatic resections at non-teaching hospitals were more than twice as likely to die following surgery compared to patients at teaching hospitals. Patients undergoing liver resection incurred an 8 percent mortality at non-teaching hospitals, compared with 5.3 percent at teaching hospitals. Patients undergoing esophageal resection fared slightly better at teaching hospitals, with 7.7 percent death rate, compared with 10.2 percent at non-teaching hospitals.

Similarly, patients were less likely to have lengthy hospital stays at teaching hospitals, suggesting fewer complications from surgery, the study found. Patients who had their esophageal or liver surgery at a non-teaching hospital were 30 percent more likely to have prolonged hospital stays.

"One of the fears that many people have is that going to a teaching hospital with medical students and residents might hinder their care bec

Contact: Nicole Fawcett
University of Michigan Health System

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