Surgeon Volume Impacts Outcomes After Shoulder Replacement

FRIDAY, June 23, 2023 (HealthDay News) -- The risk for adverse patient outcomes is lower for surgeons who average more than 10.4 shoulder replacements yearly, according to a study published online June 21 in The BMJ.

Epaminondas Markos Valsamis, M.B., B.Chir., from the University of Oxford in the United Kingdom, and colleagues conducted a prospective cohort study involving adults aged 18 years or older who had shoulder replacement surgery in public and private hospitals from 2012 to 2020 to examine the association between surgeon volume and patient outcomes. Data were included for 39,281 shoulder replacement procedures performed by 638 consultant surgeons at 416 surgical units.

The researchers examined the association between a surgeon's mean annual volume and risk for adverse patient outcomes, with a minimum volume threshold of 10.4 procedures yearly. The risk for revision surgery was significantly increased below this threshold, with as much as twice that of surgeons with the lowest risk (hazard ratio, 1.94). A significantly lower risk for reoperations, fewer serious adverse events, and shorter hospital stay were seen in association with a greater mean annual surgical volume, with no thresholds identified. There was no association seen for annual variation in surgeon volume with any of the outcomes assessed.

"Although the results of this study address the role of individual surgeon volume on patient outcomes, further work is needed to fully understand the complex interaction between this and hospital volume, especially if it is to inform any discussions around the centralization or redistribution of some treatments and services," the authors write.

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