The impact of resident involvement on post-operative morbidity and mortality following orthopaedic procedures: a study of 43,343 cases
Archives of Orthopaedic and Trauma SurgeryPublished 31 August 2013
Andrew J. Schoenfeld, Jose A. Serrano, Brian R. Waterman, Julia Bader, Philip J. Belmont
Citations113
SJR quartileQ1
SJR score1.05
SNIP1.28
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TL;DR
A mild to moderate risk for complications was noted following resident involvement in joint arthroplasty procedures, and no significant risk of post-operative morbidity or mortality was appreciated for the other orthopaedic procedures studied.
Abstract
II (Prognostic).
Keywords
Medicine
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