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Evaluating resident involvement and the ‘July effect’ in parotidectomy

Published online by Cambridge University Press:  29 April 2021

D A Benito ,
I Mamidi ,
L J Pasick ,
A D Sparks ,
C Badger ,
P Thakkar ,
J F Goodman  and
A S Joshi
D A Benito*
Affiliation:
Division of Otolaryngology–Head and Neck Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
I Mamidi
Affiliation:
Division of Otolaryngology–Head and Neck Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
L J Pasick
Affiliation:
Department of Otolaryngology–Head & Neck Surgery, University of Miami Miller School of Medicine, Miami, USA
A D Sparks
Affiliation:
Division of Otolaryngology–Head and Neck Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
C Badger
Affiliation:
Division of Otolaryngology–Head and Neck Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
P Thakkar
Affiliation:
Division of Otolaryngology–Head and Neck Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
J F Goodman
Affiliation:
Division of Otolaryngology–Head and Neck Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
A S Joshi
Affiliation:
Division of Otolaryngology–Head and Neck Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
*
Author for correspondence: Dr Daniel A Benito, Division of Otolaryngology – Head and Neck Surgery, George Washington University School of Medicine, 2300 M. Street NW, 4th Floor, Washington, DC 20037, USA E-mail: dbenito@gwu.edu Fax: +1 202 741 2238
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Abstract

Objective

This study aimed to evaluate the effect of resident involvement and the ‘July effect’ on peri-operative complications after parotidectomy.

Method

The American College of Surgeons National Surgical Quality Improvement Program database was queried for parotidectomy procedures with resident involvement between 2005 and 2014.

Results

There were 11 733 cases were identified, of which 932 involved resident participation (7.9 per cent). Resident involvement resulted in a significantly lower reoperation rate (adjusted odds ratio, 0.18; 95 per cent confidence interval, 0.05–0.73; p = 0.02) and readmission rate (adjusted odds ratios 0.30; 95 per cent confidence interval, 0.11–0.80; p = 0.02). However, resident involvement was associated with a mean 24 minutes longer adjusted operative time and 23.5 per cent longer adjusted total hospital length of stay (respective p < 0.01). No significant difference in surgical or medical complication rates or mortality was found when comparing cases among academic quarters.

Conclusion

Resident participation is associated with significantly decreased reoperation and readmission rates as well as longer mean operative times and total length of stay. Resident transitions during July are not associated with increased risk of adverse peri-operative outcomes after parotidectomy.

Keywords

Parotid GlandSurgeryInternship And Residency

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 135 , Issue 5 , May 2021 , pp. 452 - 457
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Dr D A Benito takes responsibility for the integrity of the content of the paper

Presented at the American Academy of Otolaryngology – Head and Neck Surgery Foundation, 13–16 September 2020, Boston, Massachusetts, USA.

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