Impact of Trainee Gender on Infectious Complications in Trauma

Author(s):
Nicole Lyons; Luciana Tito Bustillos; Brianna Cohen; Akshata Gunda; Victoria DeTrolio; Jessica Delamater; Larisa Shagabayeva; Michael Cobler-Lichter; Enrique Ginzburg; Nicholas Namias; Carl Schulman; Joyce Kaufman

Background:

Recent research has shown that female attending surgeons may have slightly better outcomes than male attending surgeons. We aimed to evaluate if this gender difference extends to trainees caring for trauma patients. 

Hypothesis:

We hypothesized that patients of female trainees would have lower rates of infectious complications than the patients of male trainees.

Methods:

The trauma registry at a Level 1 academic trauma center was reviewed from October 2015-December 2021. All patients admitted with an ISS>15 were included. Burns, patients that arrived without vital signs, and those with an ISS=75 were excluded. The trauma team members for each patient were determined by the past resident and fellow call schedules. All teams are staffed by the same pool of attending surgeons. Teams with two female (FF) or two male (MM) trainees were included in the analysis. The primary outcome was the presence of any infectious complication. Infectious complications included superficial and deep surgical site infection (SSI), ventilator associated pneumonia (VAP), catheter associated bloodstream infection (CLABSI), catheter associated urinary tract infection (CAUTI), and sepsis. 

Results:

2,940 patients met inclusion criteria of which 1,384 were on a FF or MM team. Notably, there were over twice as many MM teams as FF teams (n=951 vs 433). Patients on each team had similar baseline characteristics. Median age was 40 and 77.4% were male. 82% sustained blunt trauma and median injury severity score was 22. The overall rate of infectious complications on FF teams was 8.3% vs 7.5% on MM teams, p=0.588. There were also no statistically significant differences between FF and MM teams for SSI, VAP, CLABSI, CAUTI, or sepsis.

Conclusions:

There was no statistically significant difference in rate of infectious complications for severely injured trauma patients based on whether the trainees on their team were men or women. As gender discrimination still persists in the field of surgery, studies, such as this, which demonstrate similar or better outcomes for women surgeons can help to dissipate bias.