"July Effect " in Spinal Fusions: A Coarsened Exact-Matched Analysis

被引:0
|
作者
Borja, Austin J. [1 ]
Ahmad, Hasan S. [1 ]
Tomlinson, Samuel B. [1 ]
Na, Jianbo [1 ,2 ]
McClintock, Scott D. [3 ,4 ]
Welch, William C. [1 ]
Marcotte, Paul J. [1 ]
Ozturk, Ali K. [1 ]
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
关键词
July effect; Outcomes; Hospital readmissions; Spine surgery; Lumbar fusion; Resident training; QUALITY IMPROVEMENT PROGRAM; RESIDENT INVOLVEMENT; OUTCOMES; IMPACT; MORBIDITY; MORTALITY; SURGERY;
D O I
10.1227/neu.0000000000002256
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
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.
引用
收藏
页码:623 / 631
页数:9
相关论文
共 50 条
  • [41] Estimating the merit-order effect using coarsened exact matching: Reconciling theory with the empirical results to improve policy implications
    Rinne, Sonja
    ENERGY POLICY, 2024, 185
  • [42] EXACT VERSUS ASYMPTOTIC ANALYSIS FOR A MATCHED CASE-CONTROL STUDY
    HIRJI, KF
    ELASHOFF, RM
    MOORE, DH
    BENNETT, DE
    STATISTICS IN MEDICINE, 1988, 7 (07) : 765 - 772
  • [43] Trends and Outcomes in Patients with Dementia Undergoing Spine Fusions: A Matched Nationwide Inpatient Sample Analysis
    Sharma, Mayur
    Dietz, Nicholas
    Scott, Victoria
    Wang, Dengzhi
    Ugiliweneza, Beatrice
    Boakye, Maxwell
    WORLD NEUROSURGERY, 2023, 169 : E164 - E170
  • [44] TO DIVERT OR NOT? A COARSENED EXACT MATCHED COHORT COMPARING PRIMARY ANASTOMOSIS WITH OR WITHOUT DIVERSION FOR ACUTE PERFORATED DIVERTICULITIS IN THE EMERGENCY SETTING USING THE ACS-NSQIP DATABASE.
    Raheem, F. Abdul
    Marinescu, D.
    Abou Khalil, M.
    Wong-Chong, N.
    Pang, A.
    Morin, N.
    Vasilevsky, C.
    Boutros, M.
    DISEASES OF THE COLON & RECTUM, 2021, 64 (05)
  • [45] Effect of Alcohol Use on Injection and Sexual Behavior among People Who Inject Drugs in Tehran, Iran: A Coarsened Exact Matching Approach
    Noroozi, Mehdi
    Marshall, Brandon D. L.
    Noroozi, Alireza
    Armoon, Bahram
    Sharifi, Hamid
    Qorbani, Mostafa
    Abbasi, Mohammad
    Bazrafshan, Mohammad Rafi
    JOURNAL OF RESEARCH IN HEALTH SCIENCES, 2018, 18 (02)
  • [46] Influence of Race on Early Outcomes of Elective Lumbar Interbody Fusions: Propensity-Matched and Subgroup Analysis
    Alomari, Safwan
    Bydon, Ali
    Porras, Jose
    Judy, Brendan
    Witham, Timothy
    JOURNAL OF NEUROSURGERY, 2021, 135 (02) : 53 - 53
  • [47] Bone Morphogenetic Protein in Anterior Lumbar Interbody Fusions: A Propensity- Matched Medicare Outcome Analysis
    Khalid, Syed I.
    Nunna, Ravi S.
    Shanker, Rachyl M.
    Thomson, Kyle B.
    Parola, Rown
    Adogwa, Owoicho
    Mehta, Ankit I.
    INTERNATIONAL JOURNAL OF SPINE SURGERY, 2022, 16 (04): : 706 - 713
  • [48] Early Outcomes of Muscle Flap Closures in Posterior Thoracolumbar Fusions: A Propensity-Matched Cohort Analysis
    Gong, Jung Ho
    Sastry, Rahul
    Koh, Daniel J.
    Soliman, Luke
    Sobti, Nikhil
    Oyelese, Adetokunbo A.
    Gokaslan, Ziya L.
    Fridley, Jared
    Woo, Albert S.
    WORLD NEUROSURGERY, 2023, 180 : E392 - E407
  • [49] The effect of July admission on inpatient outcomes following spinal surgery Clinical article
    McDonald, Jennifer S.
    Clarke, Michelle J.
    Helm, Gregory A.
    Kallmes, David F.
    JOURNAL OF NEUROSURGERY-SPINE, 2013, 18 (03) : 280 - 288
  • [50] Does State Malpractice Environment Affect Outcomes Following Spinal Fusions? A Machine Learning Analysis
    Chan, Andrew K. H.
    Santacatterina, Michele
    Pennicooke, Brenton H.
    Shahrestani, Shane
    Ballatori, Alexander
    Burke, John F.
    Manley, Geoffrey T.
    Tarapore, Phiroz E.
    Huang, Michael C.
    Dhall, Sanjay S.
    Chou, Dean
    Mummaneni, Praveen V.
    DiGiorgio, Anthony M.
    NEUROSURGERY, 2020, 67 : 34 - 35