{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:07:07Z","timestamp":1792098427360,"version":"4.4.0"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2015,10,28]],"date-time":"2015-10-28T00:00:00Z","timestamp":1445990400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005370","name":"Gates Cambridge Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005370","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    It is widely accepted that the performance of the operating surgeon affects outcomes, and this has led to the publication of surgical results in the public domain. However, the effect of other members of the multidisciplinary team is unknown. We studied the effect of the anaesthetist on mortality after cardiac surgery by analysing data collected prospectively over ten years of consecutive cardiac surgical cases from ten\n                    <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content>\n                    centres. Casemix\u2010adjusted outcomes were analysed in models that included random\u2010effects for centre, surgeon and anaesthetist. All cardiac surgical operations for which the Euro\n                    <jats:styled-content style=\"fixed-case\">SCORE<\/jats:styled-content>\n                    model is appropriate were included, and the primary outcome was in\u2010hospital death up to three months postoperatively. A total of 110 769 cardiac surgical procedures conducted between April 2002 and March 2012 were studied, which included 127 consultant surgeons and 190 consultant anaesthetists. The overwhelming factor associated with outcome was patient risk, accounting for 95.75% of the variation for in\u2010hospital mortality. The impact of the surgeon was moderate (intra\u2010class correlation coefficient 4.00% for mortality), and the impact of the anaesthetist was negligible (0.25%). There was no significant effect of anaesthetist volume above ten cases per year. We conclude that mortality after cardiac surgery is primarily determined by the patient, with small but significant differences between surgeons. Anaesthetists did not appear to affect mortality. These findings do not support public disclosure of cardiac anaesthetists' results, but substantially validate current\n                    <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content>\n                    cardiac anaesthetic training and practice. Further research is required to establish the potential effects of very low anaesthetic caseloads and the effect of cardiac anaesthetists on patient morbidity.\n                  <\/jats:p>","DOI":"10.1111\/anae.13291","type":"journal-article","created":{"date-parts":[[2015,10,28]],"date-time":"2015-10-28T21:38:00Z","timestamp":1446068280000},"page":"138-146","source":"Crossref","is-referenced-by-count":66,"title":["The contribution of the anaesthetist to risk\u2010adjusted mortality after cardiac surgery"],"prefix":"10.1111","volume":"71","author":[{"given":"O.","family":"Papachristofi","sequence":"first","affiliation":[{"name":"MRC Biostatistics Unit Institute of Public Health Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. D.","family":"Sharples","sequence":"additional","affiliation":[{"name":"Clinical Trials Research Unit University of Leeds Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. H.","family":"Mackay","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Papworth Hospital Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. A. M.","family":"Nashef","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery Papworth Hospital Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. N.","family":"Fletcher","sequence":"additional","affiliation":[{"name":"Departments of Anaesthesia and Critical Care St Georges University Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. A.","family":"Klein","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Papworth Hospital Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Association of Cardiothoracic Anaesthetists (ACTA)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,10,28]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2004.09.005"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.330.7483.142"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e5661"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f3011"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)61116-8"},{"key":"e_1_2_7_7_1","unstructured":"World Health Organization.Surgical safety checklist.2009.http:\/\/whqlibdoc.who.int\/publications\/2009\/9789241598590eng Checklist.pdf (accessed 12\/07\/2015)."},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-198502000-00002"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/68.1.6"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2013.07.004"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000000522"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa035205"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-139-8-200310210-00009"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1010-7940(99)00134-7"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1010-7940(03)00074-5"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1191\/1740774505cn082oa"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0258(20001015)19:19<2675::AID-SIM556>3.0.CO;2-A"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/1536867X0300300102"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-11-77"},{"key":"e_1_2_7_20_1","volume-title":"R: A Language and Environment for Statistical Computing","author":"Team RC","year":"2014"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2004.09.003"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000084551.52010.3B"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.46.6.1526"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.316.7146.1701"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e3181a913e1"},{"key":"e_1_2_7_26_1","first-page":"112","volume-title":"The Naked Surgeon: The Power and Peril of Transparency in Medicine","author":"Nashef S","year":"2015"}],"container-title":["Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fanae.13291","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/anae.13291","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/anae.13291","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/anae.13291","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T01:24:33Z","timestamp":1761701073000},"score":1,"resource":{"primary":{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/10.1111\/anae.13291"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,10,28]]},"references-count":25,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2016,2]]}},"alternative-id":["10.1111\/anae.13291"],"URL":"https:\/\/doi.org\/10.1111\/anae.13291","archive":["Portico"],"relation":{},"ISSN":["0003-2409","1365-2044"],"issn-type":[{"value":"0003-2409","type":"print"},{"value":"1365-2044","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,10,28]]}}}