RESUMO
BACKGROUND: Obstetric and gynecological (OBGYN) surgery is becoming increasingly complex due to an aging population with increasing rates of medical comorbidities and obesity. Complications are therefore common, and impact not only the patient but can also cause distress to the OBGYN surgeon as a "second victim". OBJECTIVE: The objective of our study was to describe and quantify the range of impacts of complications on OBGYN surgeons and assess sociodemographic, clinician and practice factors associated with such impact. STUDY DESIGN: A cross-sectional survey was developed based on interviews with OBGYNs and a review of the literature. The survey assessed OBGYN's demographic, clinical and practice characteristics, estimated number of complications per year, distress, physical and mental health, sleep, relationship impact caused by complications, and explored strategies OBGYNs used to cope with complications. Univariate logistic regression analyses were used to determine the association between OBGYNs characteristics, and complication consequences. RESULTS: Overall, of 727 survey respondents, 431 (61%) were female, 384 (55%) were 50 years or older, almost half had worked as OBGYN for 15 years or more (329 (45%)), and 527 (73%) usually complete fewer than 10 surgical procedures per week. Most (568 (78%)) reported fewer than three surgical complications per year, and most (472 (66%)) thought this was similar or less than their colleagues. Complications caused most stress when they resulted in poor patient outcomes (653 (90%)), had severe patient consequences (630 (87%)) or were a result of surgeon error (627 (86%)). Complications impacted the majority of OBGYN's wellbeing and sleep. A greater proportion of those younger than 50 years old reported that their mental wellbeing (32(10%), p=0.002) and sleep (130(42%), p=0.03) were affected when a complication occurred. Females were also more likely to report that their physical health (14(3%), p=<0.001), mental health (39(9%), p=0.01) and sleep (183(43%), p=<0.001) were affected. Current trainees (11(10%)) and surgeons with less than 15 years of experience (25(9%)) were more likely to experience mental wellbeing consequences when compared to surgeons of ≥15 years experience (12(4%))(p=0.01). Females reported less willingness to interact with colleagues when complications occurred (323(75%), p=0.006) and surgeons with less than 15 years of training were less likely to report comfort in talking (221(74%), p=0.03) and interacting with others (212(74%), p=0.02). CONCLUSION: The vast majority of OBGYN experience major impact on their health and wellbeing when one of their patients develops a complication. The degree and type of impact reported is similar to those experienced by other surgical specialties. Future studies are needed that test interventions to alleviate the significant impact and follow OBGYNs longitudinally to understand how long the impact of complications lasts.