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Examining the “July effect” on patients undergoing pituitary surgery
Author(s) -
Bashjawish Bassel,
Patel Shreya,
Kılıç Suat,
Hsueh Wayne D.,
Liu James K.,
Baredes Soly,
Eloy Jean Anderson
Publication year - 2018
Publication title -
international forum of allergy and rhinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.503
H-Index - 46
eISSN - 2042-6984
pISSN - 2042-6976
DOI - 10.1002/alr.22164
Subject(s) - medicine , surgery , comorbidity , retrospective cohort study , complication , cohort , cerebral edema , demographics , urinary system , anesthesia , demography , sociology
Background Our aim in this study was to assess the impact of the turnover of residents in July on patients undergoing pituitary surgery. Methods This work was a retrospective cohort study of cases from the National Inpatient Sample (NIS). Patients who underwent pituitary surgery from 2005 to 2012 were selected in the NIS. Patients undergoing surgery in July and in non‐July months were compared to determine differences in demographics, comorbidities, and complications. Results Of the 12,939 patients, 1098 (8.5%) underwent pituitary surgery in July. Patients receiving surgery in July had similar demographics and Agency for Healthcare Research and Quality comorbidity values compared with patients receiving surgery in other months. There were no significant differences in mortality, cerebral edema, cerebrospinal fluid leakage, iatrogenic pituitary complications, iatrogenic cerebrovascular accidents, urinary tract infections, pulmonary edema, pulmonary complications, or acute cardiac complications. There were no differences in the rate of postoperative fistulas, hematomas, perforations, or infections. The use of meningeal suturing, pedicled or free‐flap reconstruction, and skin reconstruction was more frequent in July. Finally, hospitalization costs in July were similar to costs in other months. Conclusion The turnover of new residents in July showed no change in complication rates for patients undergoing pituitary surgery. Patient care in July is similar to care during other months, demonstrating that hospitals are adequately supervising surgical residents during this transition.