July–As Good a Time as Any to Be Injured
- 1 November 2009
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in The Journal of Trauma and Acute Care Surgery
- Vol. 67 (5), 1087-1090
- https://doi.org/10.1097/ta.0b013e3181b8441d
Abstract
Recent studies have suggested worse outcomes for patients hospitalized during the beginning of the academic calendar, though these findings have not been reproduced among trauma patients. This study compares outcomes of patients during the beginning of the academic year with those at the end of the academic year. Retrospective trauma registry analysis of a large urban level I trauma center. Patients admitted during April/May (ENDYEAR group) or July/August (FRESH group) between 1998 and 2007 were included. Demographic and injury parameters were recorded, and outcomes compared including crude mortality, complication rate, length of stay (LOS), and intensive care unit LOS (ICU-LOS). TRISS methodology was used to evaluate risk-adjusted performance. Three thousand sixty-seven patients were included in the FRESH group and 3626 in the ENDYEAR group. Groups were similar in age (36 +/- 17 years and 36 +/- 17 years, p = 0.39) and mean Injury Severity Score (8 +/- 11 and 8 +/- 10, p = 0.85). There was no difference in LOS (4.6 +/- 0.2 days versus 4.5 +/- 0.2 days, p = 0.92) or ICU-LOS (5.6 +/- 0.2 days versus 5.3 +/- 0.2 days, p = 0.96). Per patient complication rates for the FRESH and ENDYEAR groups were 6% and 6% (p = 0.8), total complication rates were 12% and 13% (p = 0.07), and crude mortality was 7% and 6% (p = 0.11), respectively. FRESH and ENDYEAR groups had similar W-Statistics (1.0 and 1.2) and z scores (3.5 and 4.4). Outcomes were similar between patients injured at the beginning of the academic year compared with the end of the academic year. Our data does not support the concept of a July effect in level I trauma centers.Keywords
This publication has 3 references indexed in Scilit:
- Is there a July Phenomenon?Journal of General Internal Medicine, 2003
- The “July phenomenon” and the care of the severely injured patient: Fact or fiction?Surgery, 2001
- Specialty Differences in the ??July Phenomenon?? for Twin Cities Teaching HospitalsMedical Care, 1993