Impact of vascular resident involvement on operative variables and outcomes in endovascular aneurysm repair
Bibliographic record
Abstract
Objective Our objective was to determine how operative variables and patient outcomes differ for endovascular aneurysm repair (EVAR) done with and without trainees. Methods A retrospective review of patients who underwent elective infrarenal EVARs with bifurcated endograft between October 1, 2017, and September 30, 2022, was carried out. The presence of vascular residents, patient demographics and comorbidities, intraoperative variables, and postoperative clinical outcomes were tabulated. Operative variables and patient outcomes were compared between cases with and without trainees using the Student t test. A multivariate analysis of fluoroscopic measures was also carried out using body mass index (BMI) as a covariate. Results A total of 148 patients were included in the study with 53 cases taking place with trainees and 95 without. There were no statistically significant differences in patient demographics or comorbidities between the groups. Cases with trainees had significantly longer surgical time (84 ± 5 minutes vs 71 ± 3 minutes; P < .01), fluoroscopy time (19 ± 1 minutes vs 14 ± 1 minutes; P < .001), and higher volumes of contrast (86 ± 6 mL vs 72 ± 3 mL, P = .02). When correcting for body mass index, cases with trainees still had longer fluoroscopy times ( P < .01). There was also a trend toward greater radiation doses with trainees (531 ± 74 mGy vs 381 ± 53 mGy; P = .10). The presence of trainees did not significantly impact patient outcomes such as mortality, length of stay, or postoperative complications. Conclusions The presence of vascular residents at EVARs increased surgical and fluoroscopy time despite the presence of two attending surgeons. This finding should be considered when optimizing trainee education while minimizing radiation exposure and its impact on patient care.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".