The impact of team familiarity on intra and postoperative cardiac surgical outcomes

Surgery. 2021 Oct;170(4):1031-1038. doi: 10.1016/j.surg.2021.05.020. Epub 2021 Jun 17.


Background: Familiarity among cardiac surgery team members may be an important contributor to better outcomes and thus serve as a target for enhancing outcomes.

Methods: Adult cardiac surgical procedures (n = 4,445) involving intraoperative providers were evaluated at a tertiary hospital between 2016 and 2020. Team familiarity (mean of prior cardiac surgeries performed by participating surgeon/nonsurgeon pairs within 2 years before the operation) were regressed on cardiopulmonary bypass duration (primary-an intraoperative measure of care efficiency) and postoperative complication outcomes (major morbidity, mortality), adjusting for provider experience, surgeon 2-year case volume before the surgery, case start time, weekday, and perioperative risk factors. The relationship between team familiarity and outcomes was assessed across predicted risk strata.

Results: Median (interquartile range) cardiopulmonary bypass duration was 132 (91-192) minutes, and 698 (15.7%) patients developed major postoperative morbidity. The relationship between team familiarity and cardiopulmonary bypass duration significantly differed across predicted risk strata (P = .0001). High (relative to low) team familiarity was associated with reduced cardiopulmonary bypass duration for medium-risk (-24 minutes) and high-risk (-27 minutes) patients. Increasing team familiarity was not significantly associated with the odds of major morbidity and mortality.

Conclusion: Team familiarity, which was predictive of improved intraoperative efficiency without compromising major postoperative outcomes, may serve as a novel quality improvement target in the setting of cardiac surgery.

Publication types

  • Observational Study
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Cardiac Surgical Procedures / ethics*
  • Cardiac Surgical Procedures / psychology
  • Heart Diseases / surgery*
  • Humans
  • Middle Aged
  • Morbidity / trends
  • Operative Time
  • Postoperative Complications / epidemiology
  • Postoperative Complications / prevention & control*
  • Postoperative Complications / psychology
  • Recognition, Psychology*
  • Retrospective Studies
  • Risk Factors
  • Surgeons / ethics*
  • Surgeons / psychology
  • Survival Rate / trends
  • Treatment Outcome
  • United States / epidemiology