Abstract
Purpose :
Gender and racial diversity in healthcare that mirrors the composition of the patient population is associated with better patient outcomes. Literature shows that sex discordance between surgeons and patients is more likely to result in adverse postoperative outcomes for common surgical procedures. No study to date has evaluated the impact of sex concordance on outcomes of ophthalmologic surgery.
Methods :
Data was collected from the Northwestern Medicine Electronic Data Warehouse (EDW) on 19,178 patients who underwent cataract surgery at Northwestern Memorial Hospital (NMH) in Chicago, IL from March 1, 2007 to March 1, 2023. The self-identified sex of the surgeon and patient, and any post-operative complications that occurred within 30 days of the surgery as marked by diagnoses codes (ICD-10), billing codes (CPT), or post-operative notes were recorded. A postoperative complication was defined by one or more of the following: endophthalmitis, choroidal hemorrhage, posterior capsular tear, retinal detachment, vitreous loss, retained lens fragments, return to OR for vitrectomy within 30 days, or any relevant complications listed in the note. Generalized Estimating Equations were used to assess the association between sex concordance and presence of postoperative complications.
Results :
Surgeon-patient sex concordance or discordance did not affect post-operative complication rates for female patients (p=0.98) or male patients (p=0.92). Female patients that have a male surgeon have 0.997 times the odds of experiencing a complication than female patients with a female surgeon. Male patients that have a female surgeon have 1.01 times the odds of experiencing a complication than male patients with a male surgeon. No significant association was found between complication and surgeon gender (p = 0.94). Male surgeons have 1.01 times the odds of having a patient with complication than female surgeons.
Conclusions :
The results from our study do not indicate any significant association between surgeon-patient sex concordance and post-surgical complications with respect to cataract surgery. Further studies are warranted to evaluate the relationship between surgeon gender, patient gender, and postoperative outcomes in other ophthalmologic procedures.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.