The impact of residency training level on early postoperative desaturation: A retrospective multicenter cohort study
Main finding · Early postoperative desaturation to < 90%Result — go to the resultAdjusted odds ratio 1.07 95% CI 1.03–1.12Authors' conclusion
Patients treated by CA1 residents have an increased risk of postoperative desaturation. Some residents show an improvement and others a decline in postoperative desaturation rate.
Study context
- Population
- Adults undergoing non-cardiac surgery under GA with extubation in the OR by residents, 2 university-affiliated hospital networks (MA and NY, US), 2005–2021378 residents
- Participants
- 140,818 adults
- Exposure
- CA1 vs CA2/3 anesthesiology residents
- Outcome
- Early postoperative desaturation (SpO2 < 90%)
Methodological detailshospital registry, multicentre
- Hospital registry
- Multicentre
Main finding
Early postoperative desaturation to < 90%
Adjusted odds ratio
1.07
95% CI 1.03–1.12
P = 0.002
CA1 vs CA2/3
aOR 1.07 (95% CI 1.03–1.12); P = 0.002
As reported in the abstract
- Desaturation to < 90% occurred in all cases
- 6.5%
Observational data: associations, not effects.
Secondary outcomes
| Outcome | aOR (95% CI) | P value | |
|---|---|---|---|
| Early postoperative desaturation to < 80% | 1.10 (1.01–1.20) | P = 0.037 | |
| 0.512Adjusted odds ratio (log scale) |
Major respiratory complication for CA2/3 residents with strong decline in desaturation improvement (subgroup)
| aOR (95% CI) | P value | ||
|---|---|---|---|
| CA2/3 with strong decline in improvementP-for-interaction = 0.056 | 1.20 (1.02–1.42) | P = 0.026 | |
| 0.512Adjusted odds ratio (log scale) |
| Outcome | P value |
|---|---|
| Major respiratory complication · 7 days after surgeryDid not differ | P = 0.52 |
- Early postoperative desaturation to < 80% — Desaturation to < 80% occurred in all cases
- 1.6%
- Major respiratory complication for CA2/3 residents with strong decline in desaturation improvement (subgroup): p-for-interaction = 0.056
Change in desaturation rate from CA1 to CA2/3 (trajectory)
- Varied substantially, aOR from (decreased risk)
- 0.80
- To (increased risk)
- 1.33
Original publication
The impact of residency training level on early postoperative desaturation: A retrospective multicenter cohort study. J Clin Anesth. Published 26 August 2023. doi:10.
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