Gestern gab es eine Diskussion zu männlichen und weiblichen Chirurgen und insbesondere ob die weiblichen Chirurgen im Schnitt besser sind.
Ich habe mal Google Scholar angeworfen:
1. Comparison of postoperative outcomes among patients treated by male and female surgeons: a population based matched cohort study (2017)
Abstract
Objective To examine the effect of surgeon sex on postoperative outcomes of patients undergoing common surgical procedures.
Design Population based, retrospective, matched cohort study from 2007 to 2015.
Setting Population based cohort of all patients treated in Ontario, Canada.
Participants Patients undergoing one of 25 surgical procedures performed by a female surgeon were matched by patient age, patient sex, comorbidity, surgeon volume, surgeon age, and hospital to patients undergoing the same operation by a male surgeon.
Interventions Sex of treating surgeon.
Main outcome measure The primary outcome was a composite of death, readmission, and complications. We compared outcomes between groups using generalised estimating equations.
Results 104 630 patients were treated by 3314 surgeons, 774 female and 2540 male. Before matching, patients treated by female doctors were more likely to be female and younger but had similar comorbidity, income, rurality, and year of surgery. After matching, the groups were comparable. Fewer patients treated by female surgeons died, were readmitted to hospital, or had complications within 30 days (5810 of 52 315, 11.1%, 95% confidence interval 10.9% to 11.4%) than those treated by male surgeons (6046 of 52 315, 11.6%, 11.3% to 11.8%; adjusted odds ratio 0.96, 0.92 to 0.99, P=0.02). Patients treated by female surgeons were less likely to die within 30 days (adjusted odds ratio 0.88; 0.79 to 0.99, P=0.04), but there was no significant difference in readmissions or complications. Stratified analyses by patient, physician, and hospital characteristics did not significant modify the effect of surgeon sex on outcome. A retrospective analysis showed no difference in outcomes by surgeon sex in patients who had emergency surgery, where patients do not usually choose their surgeon.
Conclusions After accounting for patient, surgeon, and hospital characteristics, patients treated by female surgeons had a small but statistically significant decrease in 30 day mortality and similar surgical outcomes (length of stay, complications, and readmission), compared with those treated by male surgeons. These findings support the need for further examination of the surgical outcomes and mechanisms related to physicians and the underlying processes and patterns of care to improve mortality, complications, and readmissions for all patients.
Also relativ kleine Unterschiede, allerdings zugunsten der weiblichen Chirurgen
2. Does Surgeon Sex Matter? Practice Patterns and Outcomes of Female and Male Surgeons (2018)
Objective:
We sought to compare postoperative outcomes of female surgeons (FS) and male surgeons (MS) within general surgery.
Summary of Background Data:
FS in the workforce are increasing in number. Female physicians provide exceptional care in other specialties. Differences in surgical outcomes of FS and MS have not been examined.
Methods:
We linked the AMA Physician Masterfile to discharge claims from New York, Florida, and Pennsylvania (2012 to 2013) to examine practice patterns and to compare surgical outcomes of FS and MS. We paired FS and MS operating at the same hospital using cardinality matching with refined balance and compared inpatient mortality, any postoperative complication, and prolonged length of stay (pLOS) in FS and MS.
Results:
Overall practice patterns differed between the 663 FS and 3219 MS. We identified 2462 surgeons (19% FS, 81% MS) at 429 hospitals who met inclusion criteria for outcomes analysis. FS were younger (mean age ± SD FS: 48.5 ± 8.4 years, MS: 54.3 ± 9.4y; P < 0.001) with less clinical experience (mean years ± SD FS: 11.6 ± 8.3 y, MS: 17.6 ± 10.0 years; P < 0.001) than MS before matching. FS had lower rates of inpatient mortality (FS: 1.51%, MS: 2.30%; P < 0.001), any postoperative complication (FS: 12.6%, MS: 16.1%; P < 0.001), and pLOS (FS: 18.4%, MS: 20.7%; P < 0.001) before matching. After matching, FS and MS outcomes were equivalent.
Conclusion:
Surgeon practice patterns vary by sex and experience. FS and MS with similar characteristics who treat similar patients at the same hospital have equivalent rates of inpatient morality, postoperative complications, and prolonged length of hospital stay. Patients should select the surgeon who is the best fit for them regardless of sex.
Hier wurde kein Unterschied festgestellt, wenn man schaut, dass man die Ärzte und Patienten jeweils auf der gleichen Ebene vergleicht. Das scheint mir auch eines der größten Probleme zu sein, wenn man die Frage richtig beantworten will. Die Studie sagt aus:
„FS und MS mit ähnlichen Merkmalen, die ähnliche Patienten im selben Krankenhaus behandeln, haben die gleichen Raten an stationärer Sterblichkeit, postoperativen Komplikationen und verlängertem Krankenhausaufenthalt. Die Patienten sollten den Chirurgen wählen, der für sie am besten geeignet ist, unabhängig vom Geschlecht.“
3. Differences in Cholecystectomy Outcomes and Operating Time Between Male and Female Surgeons in Sweden (2023)
IMPORTANCE
Female surgeons are still in the minority worldwide, and highlighting gender differences in surgery is important in understanding and reducing inequities within the surgical specialty. Studies on different surgical procedures indicate equal results, or safer outcomes, for female surgeons, but it is still unclear whether surgical outcomes of gallstone surgery differ between female and male surgeons.
OBJECTIVE
To examine the association of the surgeon’s gender with surgical outcomes and operating time in elective and acute care cholecystectomies.
DESIGN, SETTING, AND PARTICIPANTS
A population-based cohort study based on data from the Swedish Registry of Gallstone Surgery was performed from January 1, 2006, to December 31, 2019. The sample included all registered patients undergoing cholecystectomy in Sweden during the study period. The follow-up time was 30 days. Data analysis was performed from September 1 to September 7, 2022, and updated March 24, 2023.
EXPOSURE
The surgeon’s gender.
MAIN OUTCOME(S) AND MEASURE(S)
The association between the surgeon’s gender and surgical outcomes for elective and acute care cholecystectomies was calculated with generalized estimating equations. Differences in operating time were calculated with mixed linear model analysis.
RESULTS
A total of 150 509 patients, with 97 755 (64.9%) undergoing elective cholecystectomies and 52 754 (35.1%) undergoing acute care cholecystectomies, were operated on by 2553 surgeons, including 849 (33.3%) female surgeons and 1704 (67.7%) male surgeons. Female surgeons performed fewer cholecystectomies per year and were somewhat better represented at universities and private clinics. Patients operated on by male surgeons had more surgical complications (odds ratio [OR], 1.29; 95% CI, 1.19-1.40) and total complications (OR, 1.12; 95% CI, 1.06-1.19). Male surgeons had more bile duct injuries in elective surgery (OR, 1.69; 95% CI, 1.22-2.34), but no significant difference was apparent in acute care operations. Female surgeons had significantly longer operation times. Male surgeons converted to open surgery more often than female surgeons in acute care surgery (OR, 1.22; 95% CI, 1.04-1.43), and their patients had longer hospital stays (OR, 1.21; 95% CI, 1.11-1.31). No significant difference in 30-day mortality could be demonstrated.
CONCLUSIONS AND RELEVANCE
The results of this cohort study indicate that female surgeons have more favorable outcomes and operate more slowly than male surgeons in elective and acute care cholecystectomies. These findings may contribute to an increased understanding of gender differences within this surgical specialty
Hier arbeiten die Frauen langsamer, dafür aber anscheinend auch gründlicher. Das wird den Patienten gefallen während die Krankenhäuser evtl die schnellere Behandlung abwägen müssen gegen evtl. entstehende Schadensersatzanspräche und einen schlechten Ruf.
Interessant aber auch, dass auch hier Unterschiede in den Krankenhäusern vorhanden sind. Die Frauen sind eher in Universitätsklinken und Privatkliniken als die Männer. Ich nehme mal an, dass man da evtl auch einfach mehr Zeit für einzelne Patienten hat, gerade in den Privatkliniken, weil dort ja auch mehr Geld gezahlt wird, während evtl in den öffentlichen Krankenhäusern schon der nächste Patient wartet. Auch hier wäre evtl eine Bereinigung interessant.
4. Association of Surgeon-Patient Sex Concordance With Postoperative Outcomes (2022)
Key PointsQuestion What is the association of surgeon and patient sex concordance with postoperative outcomes?
Findings In this population-based cohort study of 1 320 108 patients treated by 2937 surgeons, sex discordance between surgeon and patient was associated with a small but statistically significant increased likelihood of adverse postoperative outcomes. This was driven by worse outcomes for female patients treated by male physicians without a corresponding association among male patients treated by female physicians.
Meaning
This study found that sex discordance between surgeons and patients (particularly male surgeons and female patients) may contribute to worse surgical outcomes.
Abstract
Importance Surgeon sex is associated with differential postoperative outcomes, though the mechanism remains unclear. Sex concordance of surgeons and patients may represent a potential mechanism, given prior associations with physician-patient relationships.
Objective
To examine the association between surgeon-patient sex discordance and postoperative outcomes.
Design,
Setting, and Participants In this population-based, retrospective cohort study, adult patients 18 years and older undergoing one of 21 common elective or emergent surgical procedures in Ontario, Canada, from 2007 to 2019 were analyzed. Data were analyzed from November 2020 to March 2021.
Exposures
Surgeon-patient sex concordance (male surgeon with male patient, female surgeon with female patient) or discordance (male surgeon with female patient, female surgeon with male patient), operationalized as a binary (discordant vs concordant) and 4-level categorical variable.
Main Outcomes and Measures
Adverse postoperative outcome, defined as death, readmission, or complication within 30-day following surgery. Secondary outcomes assessed each of these metrics individually. Generalized estimating equations with clustering at the level of the surgical procedure were used to account for differences between procedures, and subgroup analyses were performed according to procedure, patient, surgeon, and hospital characteristics.
Results
Among 1 320 108 patients treated by 2937 surgeons, 602 560 patients were sex concordant with their surgeon (male surgeon with male patient, 509 634; female surgeon with female patient, 92 926) while 717 548 were sex discordant (male surgeon with female patient, 667 279; female surgeon with male patient, 50 269). A total of 189 390 patients (14.9%) experienced 1 or more adverse postoperative outcomes. Sex discordance between surgeon and patient was associated with a significant increased likelihood of composite adverse postoperative outcomes (adjusted odds ratio [aOR], 1.07; 95% CI, 1.04-1.09), as well as death (aOR, 1.07; 95% CI, 1.02-1.13), and complications (aOR, 1.09; 95% CI, 1.07-1.11) but not readmission (aOR, 1.02; 95% CI, 0.98-1.07). While associations were consistent across most subgroups, patient sex significantly modified this association, with worse outcomes for female patients treated by male surgeons (compared with female patients treated by female surgeons: aOR, 1.15; 95% CI, 1.10-1.20) but not male patients treated by female surgeons (compared with male patients treated by male surgeons: aOR, 0.99; 95% CI, 0.95-1.03) (P for interaction = .004).
Conclusions and Relevance
In this study, sex discordance between surgeons and patients negatively affected outcomes following common procedures. Subgroup analyses demonstrate that this is driven by worse outcomes among female patients treated by male surgeons. Further work should seek to understand the underlying mechanism.
Die Studie hatten wir gestern schon.
Während die Assoziationen in den meisten Untergruppen konsistent waren, veränderte das Geschlecht der Patienten diese Assoziation signifikant, mit schlechteren Ergebnissen für weibliche Patienten, die von männlichen Chirurgen behandelt wurden (verglichen mit weiblichen Patienten, die von weiblichen Chirurgen behandelt wurden: aOR, 1,15; 95% CI, 1,10-1,20), aber nicht für männliche Patienten, die von weiblichen Chirurgen behandelt wurden (verglichen mit männlichen Patienten, die von männlichen Chirurgen behandelt wurden: aOR, 0,99; 95% CI, 0,95-1,03) (P für Interaktion = .004).
Aus der Studie:
- 1 320 108, 2937 surgeons,
- 602 560 patients were sex concordant with their surgeon
- male surgeon with male patient, 509 634;
- female surgeon with female patient, 92 926
- 717 548 were sex discordant
- male surgeon with female patient, 667 279;
- female surgeon with male patient, 50 269
Wenn ich das richtig sehe, dann hätten wir folgendes Verhältnis:
- Gleiches Geschlecht
- m/m:509.634/602.560= 85% Männer
- f/f: 92 926/602.560= 15%
- Unterschiedliches Geschlecht: 717.548
- m/f: 667279/717548=93%
- f/m=7%
Anscheinend lassen sich Frauen lieber als Männer von Männern operieren oder werden eher von Männern operiert.
Es wäre also – wenn ich es richtig verstehe – durchaus möglich, dass das Mißtrauen der Frauen gegenüber weiblichen Chirurgen dazu führt, dass sie von Frauen nur die leichteren Behandlungen durchführen lassen. Aber das ist Spekulation, wir haben gerade keine Daten dazu, welche Schwere die Operation hatte.
Das scheinen mir die hauptsächlichen Studien zu dem Thema zu sein, wer andere kennt der kann sie natürlich gerne posten
Gefällt mir Wird geladen …
Alles Evolution 