- 期刊
Comparison of Cranial Procedure Exposure among Neurosurgery Residents Between E-Da Hospital and the United States
摘要
Objective: The purpose of this study was to compare the quantity of adult cranial surgeries attended by neurosurgical residents before completion of their training between E-Da Hospital and their counterparts in the United States (US) according to the US national database. Methods: The quantity and category of cranial surgery at E-Da Hospital were extracted from the hospital billing system between the year 2006 and 2017. The data were coded according to the Accreditation Council for Graduate Medical Education (ACGME) guidelines to enable a fair comparison with the US database. Linear regression analyses were conducted to identify changes in each surgical category during the study period. Results: Each of the five neurosurgery r esidents a t E-Da H ospital p articipated in an annual average of 566.80 total cranial procedures during the last four years of their residency training with the total caseloads decreasing by 37.84 cases each year (r^2 = 0.78). The national average in the US was 577.04 cranial procedures for each of the 1,631 residents over the same four-year period with an annual increase of 26.59 cases (r^2 = 0.99). Neurosurgery residents at E-Da Hospital participated in significantly more trauma (mean 2 29.00 ± 3 2.98) and tumor (mean 194.40 ± 48.65) procedures than those in the US (means 102.17±7.87 and 158.38±4.39, respectively), while the US offered t heir residents a significantly higher exposure to vascular (mean 84.37 ± 2.61), functional (mean 68.23 ± 6.01), radiosurgery (mean 17.64±4.56), and extracranial (mean 14.01±0.79) procedures than that at E-Da Hospital (means 37.60 ± 16.43, 11.60 ± 4.51, 1.60±3.05 and 1.00±1.22, respectively). E-Da Hospital and the US provided comparable exposure of cerebral spinal fluid (CSF) shunting procedures (means 60.00 ± 23.56 and 76.12 ± 2.15, respectively) and endoscopic transsphenoidal surgeries (ETSS) (means 27.40 ± 13.03 and 33.10±1.85, respectively) for their residents. Conclusions: The categories of cranial procedures to which neurosurgery residents were exposed were different between E-Da Hospital and the US. When resident case logs were e valuated in different settings (i.e., from regional, national, to international), valuable information residency trainings could be obtained.