Safety and feasibility of a single-surgeon cardiac surgery program during workforce shortage: a propensity-matched cohort study

OBJECTIVES: This study compared clinical outcomes of cardiac surgeries performed by a single surgeon (operating alone [OA]) versus those performed by multiple surgeons (operating together [OT]) to evaluate the feasibility and safety of different surgical staffing models. METHODS: We retrospectively reviewed adult patients who underwent cardiac surgery at Chung-Ang University Hospital from September 2016 to August 2021. Between September 2016 and August 2018, two or three surgeons assisted each other (OT), while from September 2018 to August 2021, a single surgeon operated alone (OA). After propensity score matching, 79 patients were selected in each group for analysis. RESULTS: Major postoperative adverse events, including mortality, stroke, new-onset atrial fibrillation, and low cardiac output, did not statistically significant differ between groups. Other postoperative outcomes such as, acute kidney injury, ICU stay length, hospital days, CPB time, ACC time was not statistically different, whereas operation time was shorter in the OT group than in the OA group (median 300 vs. 379 min, P < 0.001). CONCLUSIONS: Except for differences in operation time, there were not significantly different short-term postoperative outcomes in OT and OA groups. Given the various limitations of the present study, the result should be interpreted cautiously.