The conference effect: National surgery meetings are associated with increased mortality at trauma centers without American College of Surgeons verification

PLoS One. 2019 Mar 26;14(3):e0214020. doi: 10.1371/journal.pone.0214020. eCollection 2019.

Abstract

Background: Thousands of physicians attend scientific conferences each year. While recent data indicate that variation in staffing during such meetings impacts survival of non-surgical patients, the association between treatment during conferences and outcomes of a surgical population remain unknown. The purpose of this study was to examine mortality resulting from traumatic injuries and the influence of hospital admission during national surgery meetings.

Study design: Retrospective analysis of in-hospital mortality using data from the Trauma Quality Improvement Program (2010-2011). Identified patients admitted during four annual meetings and compared their mortality with that of patients admitted during non-conference periods. Analysis included 155 hospitals with 12,256 patients admitted on 42 conference days and 82,399 patients admitted on 270 non-conference days. Multivariate analysis performed separately for hospitals with different levels of trauma center verification by state and American College of Surgeons (ACS) criteria.

Results: Patient characteristics were similar between meeting and non-meeting dates. At ACS level I and level II trauma centers during conference versus non-conference dates, adjusted mortality was not significantly different. However, adjusted mortality increased significantly for patients admitted to trauma centers that lacked ACS trauma verification during conferences versus non-conference days (OR 1.2, p = 0.008), particularly for patients with penetrating injuries, whose mortality rose from 11.6% to 15.9% (p = 0.006).

Conclusions: Trauma mortality increased during surgery conferences compared to non-conference dates for patients admitted to hospitals that lacked ACS trauma level verification. The mortality difference at those hospitals was greatest for patients who presented with penetrating injuries.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Congresses as Topic*
  • Female
  • Hospital Mortality
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Patient Admission
  • Personnel Staffing and Scheduling / standards
  • Personnel Staffing and Scheduling / statistics & numerical data
  • Quality Improvement
  • Retrospective Studies
  • Societies, Medical* / standards
  • Surgeons
  • Surgical Procedures, Operative / mortality
  • Surgical Procedures, Operative / standards
  • Trauma Centers* / standards
  • United States
  • Wounds and Injuries / mortality*
  • Wounds and Injuries / surgery*
  • Young Adult