Abstract
Background
Preliminary evidence demonstrates female surgeons have improved post-operative outcomes compared to male colleagues despite underrepresentation in surgery. This study explores the effect of patient-surgeon gender discordance on outcomes in three specialties with high female patient populations: bariatric, foregut, colorectal.
Methods
This is a retrospective study using the New York State (NYS) SPARCS database and first study evaluating outcomes based on surgeon/patient concordance in NYS. Bariatric, foregut, and colorectal surgery cases from 2013 to 2017 were identified.
Results
Bariatric: female patients (FP) with CC had lower 30-day readmissions but higher complications compared with DC. Male patients (MP) with CC trended towards higher 30-day readmissions but lower complications compared with DC. FP received significantly better influence from CC in 30-day readmission, but disadvantages in complications. There was no significant difference in LOS or ED visits between CC and DC groups for either FP or MP. Foregut: FP with CC had lower LOS, 30-day readmissions, and 30-day ED visits compared with DC. MP showed opposite trends between CC and DC, although non-significant. The benefit from concordance was pronounced in FP compared to MP in LOS, 30-day readmissions, and 30-day ED visit. Concordance vs discordance did not significantly affect complications within either FP or MP group. Colorectal: the difference between CC and DC was not significant within FP or MP groups in any outcomes. When comparing the difference of 30-day readmissions in CC vs DC between FP and MP, there is a significant difference.
Conclusion(s)
Overall, our results show DC between patient and surgeon has significant effect on patient outcomes. A negative effect is seen for female patients in certain specialties, most pronounced in foregut surgery. This emphasizes need for surgeons to be conscious of care provided to opposite gender patients and underscores increasing female surgeons in high FP fields.
Graphical abstract
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Acknowledgements
Thank you to SAGES for the Medical Student Summer Research Award which funded the statistical analysis of this study. We acknowledge the biostatistical consultation and support provided by the Biostatistical Consulting Core at School of Medicine, Stony Brook University.
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SAGES Medical Student Summer Research Award funded the statistical analysis of this study.
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Dr. Konstantinos Spaniolas is a speaker for Medtronic, Gore and Intuitive. Dr. Aurora D Pryor is a speaker for Medtronic, Stryker and Gore. She is an officer for SAGES Ingenuity. Caroline Smolkin, Xiaoyue Zhang, Ila Sethi, Adrian Torres, and Jie Yang has no disclosures to report.
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Smolkin, C., Zhang, X., Sethi, I. et al. Effect of gender discordance on surgical outcomes in predominantly female patient surgeries in NYS. Surg Endosc 38, 1556–1567 (2024). https://doi.org/10.1007/s00464-023-10595-9
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DOI: https://doi.org/10.1007/s00464-023-10595-9