- Effective teamwork is especially central to patient safety during cardiac surgery, requiring close coordination between the surgeon and anesthesiologist to optimize perioperative outcomes.
- This retrospective cohort study examined whether the frequency with which a surgeon and anesthesiologist work together is associated with differences in operative mortality and other perioperative outcomes.
- 16,811 adult cardiac surgical procedures conducted between 2011 and 2024 at a single academic center were analyzed in this study, encompassing 481 unique surgeon–anesthesiologist pairings.
- Team familiarity was quantified as the number of cases a specific surgeon–anesthesiologist pair completed together in the prior year and was stratified into quintiles.
- The primary endpoint was operative mortality, defined as death before hospital discharge or within 30 days of surgery.
- Secondary endpoints included procedure duration, ICU and hospital length of stay, reoperation, readmission, transfusion, and major postoperative complications.
- Mortality rates declined as team familiarity increased, with the surgeon-anesthesiologist dyads performing the fewest surgeries together demonstrating the highest mortality, and the most frequently collaborating dyads demonstrating the lowest. After risk adjustment, patients cared for by the least familiar dyads had nearly twice the odds of operative death compared with those treated by the most familiar teams (OR 1.90; 95% CI, 1.29–2.81; P = 0.001).
- Less familiar teams were also associated with longer operations, extended ICU and hospital stays, higher transfusion rates, and increased pulmonary and neurologic complications. These associations persisted in sensitivity analyses that accounted for individual clinician experience and excluded the highest-volume surgeons.
- For anesthesia professionals, these findings underscore the potential safety benefits of consistent collaboration with surgical colleagues. Familiarity within the dyad may enhance communication, anticipation of critical events such as separation from cardiopulmonary bypass, and shared decision-making under pressure.
- Organizational approaches that support stable cardiac anesthesia–surgery pairings may represent a modifiable systems-level strategy to improve perioperative outcomes and reduce preventable harm.
Summary of "The Association Between Surgeon-Anesthesiologist Dyad Familiarity and Operative Mortality: A Retrospective Study at a Large Academic Cardiac Surgery Program"
Summary published June 8, 2026
