Objectives: To analyze post-surgical parotidectomy complications stratified by post graudate year (PGY) of resident involvement.
Methods: The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database was utilized to collect data on parotidectomy surgeries performed between 2005 and 2013. Only cases identifying the PGY level and status of resident participation in surgery were included. Four groups were stratified based on level of training and analyzed for comorbidities, pre-operative variables, and post-operative outcomes using SPSS.
Results: There were 4675 cases with primary surgeon data available. Out of these, 789 were performed with junior residents, 1049 with senior residents, 395 with fellows, and 2442 by an attending alone. The overall complication rate was 5.1%. On univariate analysis there was a statistically significant difference in the rate of complications between groups (5.0%, 6.6%, 9.2%, 2.9%, p<0.001). However, after controlling for all confounding variables via multivariate analysis there was no significant differences in morbidity, mortality, readmission, and reoperation. Furthermore, when comparing cases performed with residents and/or fellows versus attendings alone using multivariate analysis there was no significant difference in morbidity (OR=1.052[0.612-1.808]), mortality (OR=0), readmission (OR=2.661[0.710-9.978]), and reoperation (OR=1.199[0.143-10.087]).
Conclusion: Parotidectomy is a common procedure with a low rate of complications. When controlling for all variables there was no difference between cases performed by attendings alone versus cases with trainee involvement. Additionally, the specific PGY level had no impact on the rate of complications.