"July Effect " in Spinal Fusions: A Coarsened Exact-Matched Analysis
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作者:
Borja, Austin J.
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机构:
Univ Penn, Perelman Sch Med, Dept Neurosurg, Philadelphia, PA USAUniv Penn, Perelman Sch Med, Dept Neurosurg, Philadelphia, PA USA
Borja, Austin J.
[1
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Ahmad, Hasan S.
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机构:
Univ Penn, Perelman Sch Med, Dept Neurosurg, Philadelphia, PA USAUniv Penn, Perelman Sch Med, Dept Neurosurg, Philadelphia, PA USA
Ahmad, Hasan S.
[1
]
Tomlinson, Samuel B.
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机构:
Univ Penn, Perelman Sch Med, Dept Neurosurg, Philadelphia, PA USAUniv Penn, Perelman Sch Med, Dept Neurosurg, Philadelphia, PA USA
Tomlinson, Samuel B.
[1
]
Na, Jianbo
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机构:
Univ Penn, Perelman Sch Med, Dept Neurosurg, Philadelphia, PA USA
Univ Penn, McKenna EpiLog Fellowship Populat Hlth, Philadelphia, PA USAUniv Penn, Perelman Sch Med, Dept Neurosurg, Philadelphia, PA USA
Na, Jianbo
[1
,2
]
McClintock, Scott D.
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机构:
West Chester Univ, West Chester Stat Inst, W Chester, PA USA
West Chester Univ, Dept Math, W Chester, PA USAUniv Penn, Perelman Sch Med, Dept Neurosurg, Philadelphia, PA USA
McClintock, Scott D.
[3
,4
]
Welch, William C.
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机构:
Univ Penn, Perelman Sch Med, Dept Neurosurg, Philadelphia, PA USAUniv Penn, Perelman Sch Med, Dept Neurosurg, Philadelphia, PA USA
Welch, William C.
[1
]
Marcotte, Paul J.
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机构:
Univ Penn, Perelman Sch Med, Dept Neurosurg, Philadelphia, PA USAUniv Penn, Perelman Sch Med, Dept Neurosurg, Philadelphia, PA USA
Marcotte, Paul J.
[1
]
Ozturk, Ali K.
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机构:
Univ Penn, Perelman Sch Med, Dept Neurosurg, Philadelphia, PA USAUniv Penn, Perelman Sch Med, Dept Neurosurg, Philadelphia, PA USA
Ozturk, Ali K.
[1
]
Malhotra, Neil R.
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h-index: 0
机构:
Univ Penn, Perelman Sch Med, Dept Neurosurg, Philadelphia, PA USA
Univ Penn, McKenna EpiLog Fellowship Populat Hlth, Philadelphia, PA USA
Perelman Ctr Adv Med, Dept Neurosurg, 15th Floor, 3400 Civ Ctr Blvd, Philadelphia, PA 19104 USAUniv Penn, Perelman Sch Med, Dept Neurosurg, Philadelphia, PA USA
Malhotra, Neil R.
[1
,2
,5
]
机构:
[1] Univ Penn, Perelman Sch Med, Dept Neurosurg, Philadelphia, PA USA
[2] Univ Penn, McKenna EpiLog Fellowship Populat Hlth, Philadelphia, PA USA
[3] West Chester Univ, West Chester Stat Inst, W Chester, PA USA
[4] West Chester Univ, Dept Math, W Chester, PA USA
[5] Perelman Ctr Adv Med, Dept Neurosurg, 15th Floor, 3400 Civ Ctr Blvd, Philadelphia, PA 19104 USA
BACKGROUND: Few neurosurgical studies examine the July Effect within elective spinal procedures, and none uses an exact-matched protocol to rigorously account for confounders.OBJECTIVE: To evaluate the July Effect in single-level spinal fusions, after coarsened exact matching of the patient cohort on key patient characteristics (including race and comorbid status) known to independently affect neurosurgical outcomes.METHODS: Two thousand three hundred thirty-eight adult patients who underwent single-level, posterior-only lumbar fusion at a single, multicenter university hospital system were retrospectively enrolled. Primary outcomes included readmissions, emergency department visits, reoperation, surgical complications, and mortality within 30 days of surgery. Logistic regression was used to analyze month as an ordinal variable. Subsequently, outcomes were compared between patients with surgery at the beginning vs end of the academic year (ie, July vs April-June), before and after coarsened exact matching on key characteristics. After exact matching, 99 exactly matched pairs of patients (total n = 198) were included for analysis.RESULTS: Among all patients, operative month was not associated with adverse postoperative events within 30 days of the index operation. Furthermore, patients with surgeries in July had no significant difference in adverse outcomes. Similarly, between exact-matched cohorts, patients in July were observed to have noninferior adverse postoperative events.CONCLUSION: There was no evidence suggestive of a July Effect after single-level, posterior approach spinal fusions in our cohort. These findings align with the previous literature to imply that teaching hospitals provide adequate patient care throughout the academic year, regardless of how long individual resident physician assistants have been in their particular role.
机构:
Univ Louisville, Dept Neurosurg, Louisville, KY 40292 USAUniv Louisville, Dept Neurosurg, Louisville, KY 40292 USA
Dietz, Nicholas
Scott, Victoria
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机构:
Univ Louisville, Dept Neurosurg, Louisville, KY 40292 USAUniv Louisville, Dept Neurosurg, Louisville, KY 40292 USA
Scott, Victoria
Wang, Dengzhi
论文数: 0引用数: 0
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机构:
Univ Louisville, Dept Neurosurg, Louisville, KY 40292 USA
Univ Louisville, Kentucky Spinal Cord Injury Res Ctr, Louisville, KY USAUniv Louisville, Dept Neurosurg, Louisville, KY 40292 USA
Wang, Dengzhi
Ugiliweneza, Beatrice
论文数: 0引用数: 0
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机构:
Univ Louisville, Dept Neurosurg, Louisville, KY 40292 USA
Univ Louisville, Dept Hlth Management & Syst Sci, Louisville, KY USAUniv Louisville, Dept Neurosurg, Louisville, KY 40292 USA
Ugiliweneza, Beatrice
Boakye, Maxwell
论文数: 0引用数: 0
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机构:
Univ Louisville, Dept Neurosurg, Louisville, KY 40292 USA
Univ Louisville, Dept Hlth Management & Syst Sci, Louisville, KY USAUniv Louisville, Dept Neurosurg, Louisville, KY 40292 USA
机构:
Univ Social Welf & Rehabil Sci, Social Determinants Hlth Res Ctr, Tehran, IranUniv Social Welf & Rehabil Sci, Social Determinants Hlth Res Ctr, Tehran, Iran
Noroozi, Mehdi
Marshall, Brandon D. L.
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机构:
Brown Univ, Dept Epidemiol, Sch Publ Hlth, Providence, RI 02912 USAUniv Social Welf & Rehabil Sci, Social Determinants Hlth Res Ctr, Tehran, Iran
Marshall, Brandon D. L.
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Noroozi, Alireza
Armoon, Bahram
论文数: 0引用数: 0
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机构:
Shahid Beheshti Univ Med Sci, Sch Hlth, Student Res Comm, Tehran, IranUniv Social Welf & Rehabil Sci, Social Determinants Hlth Res Ctr, Tehran, Iran
Armoon, Bahram
Sharifi, Hamid
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机构:
Kerman Univ Med Sci, Inst Futures Studies Hlth, HIV STI Surveillance Res Ctr, Kerman, Iran
Kerman Univ Med Sci, Inst Futures Studies Hlth, WHO Collaborating Ctr HIV Surveillance, Kerman, IranUniv Social Welf & Rehabil Sci, Social Determinants Hlth Res Ctr, Tehran, Iran
Sharifi, Hamid
Qorbani, Mostafa
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机构:
Alborz Univ Med Sci, Noncommunicable Dis Res Ctr, Karaj, IranUniv Social Welf & Rehabil Sci, Social Determinants Hlth Res Ctr, Tehran, Iran
Qorbani, Mostafa
Abbasi, Mohammad
论文数: 0引用数: 0
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机构:
Qom Univ Med Sci, Sch Nursing & Midwifery, Qom, IranUniv Social Welf & Rehabil Sci, Social Determinants Hlth Res Ctr, Tehran, Iran
Abbasi, Mohammad
Bazrafshan, Mohammad Rafi
论文数: 0引用数: 0
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机构:
Larestan Univ Med Sci, Sch Nursing, Dept Nursing, Larestan, IranUniv Social Welf & Rehabil Sci, Social Determinants Hlth Res Ctr, Tehran, Iran
机构:
Univ Illinois, Dept Neurosurg, Chicago, IL USA
Rush Univ, Surg, Med Ctr, Chicago, IL USA
Univ Illinois, Chicago, IL 60607 USAUniv Illinois, Dept Neurosurg, Chicago, IL USA
Khalid, Syed I.
Nunna, Ravi S.
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Univ Illinois, Dept Neurosurg, Chicago, IL USAUniv Illinois, Dept Neurosurg, Chicago, IL USA
Nunna, Ravi S.
Shanker, Rachyl M.
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Chicago Med Sch, N Chicago, IL USAUniv Illinois, Dept Neurosurg, Chicago, IL USA
Shanker, Rachyl M.
Thomson, Kyle B.
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Chicago Med Sch, N Chicago, IL USAUniv Illinois, Dept Neurosurg, Chicago, IL USA
Thomson, Kyle B.
Parola, Rown
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Univ Illinois, Dept Neurosurg, Chicago, IL USAUniv Illinois, Dept Neurosurg, Chicago, IL USA
Parola, Rown
Adogwa, Owoicho
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Univ Texas Southwestern Med Ctr Dallas, Dept Neurosurg, Dallas, TX USAUniv Illinois, Dept Neurosurg, Chicago, IL USA
Adogwa, Owoicho
Mehta, Ankit I.
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Univ Illinois, Dept Neurosurg, Chicago, IL USAUniv Illinois, Dept Neurosurg, Chicago, IL USA
Mehta, Ankit I.
INTERNATIONAL JOURNAL OF SPINE SURGERY,
2022,
16
(04):
: 706
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713
机构:
Brown Univ, Warren Alpert Med Sch, Dept Neurosurg, Providence, RI USABrown Univ, Div Plast & Reconstruct Surg, Warren Alpert Med Sch, Providence, RI 02912 USA
Sastry, Rahul
Koh, Daniel J.
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机构:
Boston Univ, Sch Med, Boston, MA USABrown Univ, Div Plast & Reconstruct Surg, Warren Alpert Med Sch, Providence, RI 02912 USA
Koh, Daniel J.
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Soliman, Luke
Sobti, Nikhil
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机构:
Brown Univ, Div Plast & Reconstruct Surg, Warren Alpert Med Sch, Providence, RI 02912 USABrown Univ, Div Plast & Reconstruct Surg, Warren Alpert Med Sch, Providence, RI 02912 USA
Sobti, Nikhil
Oyelese, Adetokunbo A.
论文数: 0引用数: 0
h-index: 0
机构:
Brown Univ, Warren Alpert Med Sch, Dept Neurosurg, Providence, RI USABrown Univ, Div Plast & Reconstruct Surg, Warren Alpert Med Sch, Providence, RI 02912 USA
Oyelese, Adetokunbo A.
Gokaslan, Ziya L.
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机构:
Brown Univ, Warren Alpert Med Sch, Dept Neurosurg, Providence, RI USABrown Univ, Div Plast & Reconstruct Surg, Warren Alpert Med Sch, Providence, RI 02912 USA
Gokaslan, Ziya L.
Fridley, Jared
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机构:
Brown Univ, Warren Alpert Med Sch, Dept Neurosurg, Providence, RI USABrown Univ, Div Plast & Reconstruct Surg, Warren Alpert Med Sch, Providence, RI 02912 USA
Fridley, Jared
Woo, Albert S.
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机构:
Brown Univ, Div Plast & Reconstruct Surg, Warren Alpert Med Sch, Providence, RI 02912 USABrown Univ, Div Plast & Reconstruct Surg, Warren Alpert Med Sch, Providence, RI 02912 USA