Cited by 1,118Thyroid and Parathyroid SurgeryThyroid Cancer Diagnosis and TreatmentCardiac, Anesthesia and Surgical Outcomes

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The Importance of Surgeon Experience for Clinical and Economic Outcomes From Thyroidectomy

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Sosa, Julie Ann, Bowman, Helen M., Tielsch, James M., Powe, Neil R., Gordon, Toby A., Udelsman, Robert·1998·Annals of Surgery

DOI 10.1097/00000658-199809000-00005PMC PMC1191485

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Abstract

OBJECTIVE: To determine whether individual surgeon experience is associated with improved short-term clinical and economic outcomes for patients with benign and malignant thyroid disease who underwent thyroid procedures in Maryland between 1991 and 1996. SUMMARY BACKGROUND DATA: There is a prevailing belief that surgeon experience affects patient outcomes in endocrine surgery, but there is a paucity of objective evidence outside of clinical series published by experienced surgeons that supports this view. METHODS: A cross-sectional analysis of all patients who underwent thyroidectomy in Maryland between 1991 and 1996 was conducted using a computerized statewide hospital discharge data base. Surgeons were categorized by volume of thyroidectomies over the 6-year study period: A (1 to 9 cases), B (10 to 29 cases), C (30 to 100 cases), and D (>100 cases). Multivariate regression was used to assess the relation between surgeon caseload and in-hospital complications, length of stay, and total hospital charges, adjusting for case mix and hospital volume. RESULTS: The highest-volume surgeons (group D) performed the greatest proportion of total thyroidectomies among the 5860 discharges, and they were more likely to operate on patients with cancer. After adjusting for case mix and hospital volume, highest-volume surgeons had the shortest length of stay (1.4 days vs. 1.7 days for groups B and C and 1.9 days for group A) and the lowest complication rate (5.1 % vs. 6.1% for groups B and C and 8.6% for group A). Length of stay and complications were more determined by surgeon experience than hospital volume, which had no consistent association with outcomes. CONCLUSIONS: Individual surgeon experience is significantly associated with complication rates and length of stay for thyroidectomy.

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Authors: Sosa, J. A., Bowman, H. M., Tielsch, J. M., Powe, N. R., Gordon, T. A., & Udelsman, R.
Affiliations: Johns Hopkins University (US)
Corresponding author: Sosa, Julie Ann
Gordon, Toby A.
Udelsman, Robert
ORCID: Sosa, Julie Ann
Tielsch, James M.
Powe, Neil R.
Gordon, Toby A.
Venue: Annals of Surgery
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 1998-09
Volume: 228
Issue: 3
Pages: 320-330
ISSN: 0003-4932 (ISSN-L)
DOI: 10.1097/00000658-199809000-00005
PMC: PMC1191485
OpenAlex: W1981565562
Cited by: 1,118
References: 28
Citations by year: 2026: 19 · 2025: 20 · 2024: 28 · 2023: 41 · 2022: 43 · 2021: 54 · 2020: 69 · 2019: 64 · 2018: 62 · 2017: 60 · 2016: 49 · 2015: 73 · 2014: 60 · 2013: 61 · 2012: 57
FWCI: 12.23
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Annals of Surgery (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac, Anesthesia and Surgical Outcomes
Keywords: thyroidectomy, surgeon experience, surgeon volume, hospital volume, postoperative complications, length of hospital stay, hospital charges, benign thyroid disease, thyroid cancer, endocrine surgery
MeSH terms: Clinical Competence, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Postoperative Complications, General Surgery, Thyroid Diseases, Thyroidectomy, Multivariate Analysis, Treatment Outcome

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The Importance of Surgeon Experience for Clinical and Economic Outcomes From Thyroidectomy

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