Association Between Anaesthesiologists’ Sex and Anaesthesiology Quality Metrics and Postoperative Outcomes: A Retrospective Analysis

<b>Background:</b> Evidence suggests differences in medical practice and patient outcomes between male and female physicians and surgeons. To date, no such relationships were investigated in anaesthesiologists. This study aimed to investigate an association between anaesthesiologists' sex and anaesthesia quality metrics as well as outcomes. <b>Methods:</b> We performed a population-based, single-centre, retrospective cohort study. Data were gathered from all patients undergoing anaesthesia between 1 January 2014 and 31 March 2022 at a large tertiary centre in Vienna, Austria. We examined 30-day mortality in relation to the sex of the anaesthesiologist after adjusting for various patient, physician, and hospital factors. Additionally, we assessed anaesthesiologists' sex and several anaesthesia quality benchmarks. <b>Results:</b> The final dataset included 94,254 cases. The study showed a very small but statistically significant correlation between male anaesthesia providers and an elevated risk for all-cause mortality within 30 days (adjusted odds ratio [aOR]: 1.0026; 95% confidence interval [CI], 1.0003-1.0048). Both male and female anaesthesiologists demonstrated similar proficiency in managing hemodynamic stability, blood glucose levels, preventing postoperative acute kidney injury (AKI) and lung-protective ventilation. However, male anaesthesiologists showed slightly higher adherence to guidelines for PONV prophylaxis. <b>Conclusions:</b> In a dataset of nearly 95,000 cases, there was a clinically marginal but statistically significant association between male provider sex and 30-day mortality.