Emergency surgery performed by older people has lower death rate

Patients who have emergency operations from surgeons over the age of 60 are more likely to survive

  • Death rates lower when surgery was conducted by professionals aged over 60 
  • There was no difference in death rates between male and female surgeons 
  • Age and sex made no difference when considering non-emergency surgery  

Patients who have emergency operations conducted by older surgeons are more likely to survive, a study suggests.

It found slightly lower death rates after surgery by those aged over 60 compared with younger doctors at the same hospitals.

The US researchers examined mortality rates of patients aged over 65 who had one of 20 major emergency operations between 2011 and 2014.

They considered how many died either in hospital or within 30 days of surgery. In total, 45,826 surgeons treated 892,187 patients, of whom 56,803 died – a death rate of 6.4 per cent.

Patients who have emergency operations conducted by older surgeons are more likely to survive, researchers in the US have claimed 

The rate was slightly higher at 6.6 per cent for surgeons aged under 40 than for all other age groups. It was 6.3 per cent for those aged over 60, 6.4 per cent for those in their 50s and 6.5 per cent for those in their 40s.

The researchers at the University of California, Los Angeles, found there was no difference in patient death rates between male and female surgeons. For non-emergency surgery, such as hip replacements, the age and sex of the surgeon made no difference to death rates.

Researchers took into account other factors that could affect mortality, including patients’ age, sex, ethnicity and what day of the week the surgery took place. Previous studies found older surgeons tended to have worse patient outcomes, which was blamed on their tendency to rely on outdated techniques.

But the latest findings, published in the British Medical Journal, suggest older surgeons may have better skills under pressure because of their extra years of experience.

The study found no difference between sex and age when the surgery performed was classed as non-emergency 

Researchers warned the observational study did not prove cause and effect so it was not possible to confirm whether death rates were linked to surgeon age.

The authors, led by Dr Yusuke Tsugawa, said: ‘Our finding that younger surgeons have higher mortality suggests that more oversight and supervision early in a surgeon’s career may be useful and at least warrants further investigation.’

In a linked editorial, Professor Natalie Coburn, of Sunnybrook Health Sciences Centre in Toronto, Canada, said: ‘Skill erosion in senior surgeons is often discussed, but deficiencies in judgment and lack of experience may also lead to higher operative mortality and may be more prevalent in younger surgeons.’

Professor Neil Mortensen, vice-president of the Royal College of Surgeons, said: ‘The findings … suggest improved surgical skills with extra years in practice.

‘This study certainly prompts further investigation. It may also advance the cause of two-consultant operating, with an older surgeon mentoring a younger one.’  

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