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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, DC20037, USA E-mail: [email protected] 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
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.

References

Franzen, A, Buchali, A, Lieder, A. The rising incidence of parotid metastases: our experience from four decades of parotid gland surgery. Acta Otorhinolaryngol Ital 2017;37:264–9CrossRefGoogle ScholarPubMed
Iyer, NG, Clark, JR, Murali, R, Gao, K, O'Brien, CJ. Outcomes following parotidectomy for metastatic squamous cell carcinoma with microscopic residual disease: implications for facial nerve preservation. Head Neck 2009;31:21–7CrossRefGoogle ScholarPubMed
Malata, CM, Camilleri, IG, McLean, NR, Piggot, TA, Chippindale, AJ, Kelly, GC, Soames, JV. Malignant tumours of the parotid gland: a 12-year review. Br J Plast Surg 1997;50:600–8CrossRefGoogle ScholarPubMed
Sethi, RKV, Deschler, DG. National trends in inpatient parotidectomy: A fourteen-year retrospective analysis. Am J Otolaryngol 2018;39:553–7CrossRefGoogle ScholarPubMed
Kim, BD, Lim, S, Wood, J, Samant, S, Ver Halen, JP, Kim, JY. Predictors of adverse events after parotidectomy: a review of 2919 cases. Ann Otol Rhinol Laryngol 2015;124:35–44CrossRefGoogle ScholarPubMed
O'Brien, DC, Kellermeyer, B, Chung, J, Carr, MM. Experience with key indicator cases among otolaryngology residents. Laryngoscope Investigative Otolaryngology 2019;4:387–92CrossRefGoogle ScholarPubMed
Cameron, JL. William Stewart Halsted. Our surgical heritage. Ann Surg 1997;225:445–58CrossRefGoogle Scholar
Iannuzzi, JC, Rickles, AS, Deeb, AP, Sharma, A, Fleming, FJ, Monson, JR. Outcomes associated with resident involvement in partial colectomy. Dis Colon Rectum 2013;56:212–18CrossRefGoogle ScholarPubMed
Iannuzzi, JC, Chandra, A, Rickles, AS, Kumar, NG, Kelly, KN, Gillespie, DL et al. Resident involvement is associated with worse outcomes after major lower extremity amputation. J Vasc Surg 2013;58:827–31CrossRefGoogle ScholarPubMed
Abt, NB, Reh, DD, Eisele, DW, Francis, HW, Gourin, CG. Does resident participation influence otolaryngology-head and neck surgery morbidity and mortality? Laryngoscope 2016;126:2263–9CrossRefGoogle ScholarPubMed
Bohl, DD, Fu, MC, Golinvaux, NS, Basques, BA, Gruskay, JA, Grauer, JN. The “July Effect” in Primary Total Hip and Knee Arthroplasty: Analysis of 21,434 Cases From the ACS-NSQIP Database. J Arthroplasty 2014; 29:1332–8CrossRefGoogle ScholarPubMed
Hoashi, JS, Samdani, AF, Betz, RR, Bastrom, TP, Group, Harms Study, Cahill, PJ. Is there a “July Effect” in surgery for adolescent idiopathic scoliosis? J Bone Joint Surg Am 2014; 96:e55CrossRefGoogle Scholar
Nandyala, SV, Marquez-Lara, A, Fineberg, SJ, Singh, K. Perioperative characteristics and outcomes of patients undergoing anterior cervical fusion in July: analysis of the “July effect.” Spine 2014; 39:612–17CrossRefGoogle ScholarPubMed
Karipineni, F, Panchal, H, Khanmoradi, K, Parsikhia, A, Ortiz, J. The “July effect” does not have clinical relevance in liver transplantation. J Surg Educ 2013;70:669–79CrossRefGoogle Scholar
Young, JQ, Ranji, SR, Wachter, RM, Lee, CM, Niehaus, B, Auerbach, AD. “July effect”: impact of the academic year-end changeover on patient outcomes: a systematic review. Ann Intern Med 2011;155:309–15CrossRefGoogle ScholarPubMed
Hennessey, PT, Francis, HW, Gourin, CG. Is there a “July effect” for head and neck cancer surgery? Laryngoscope 2013;123:1889–95CrossRefGoogle Scholar
Bresler, AY, Bavier, R, Kalyoussef, E, Baredes, S, Park, RCW. The “July effect”: Outcomes in microvascular reconstruction during resident transitions. Laryngoscope 2020; 130:893–8CrossRefGoogle ScholarPubMed
Bashjawish, B, Patel, S, Kılıç, S, Hsueh, WD, Liu, JK, Baredes, S et al. Examining the “July effect” on patients undergoing pituitary surgery. Int Forum Allergy Rhinol 2018;8:1157–61CrossRefGoogle ScholarPubMed
American College of Surgeons. ACS NSQIP participant use data file. In: https://www.facs.org/quality-programs/acs-nsqip/about/participants [25 March 2020]Google Scholar
Vieira, BL, Hernandez, DJ, Qin, C, Smith, SS, Kim, JYS, Dutra, JC. The impact of resident involvement on otolaryngology surgical outcomes. Laryngoscope 2016;126:602–7CrossRefGoogle ScholarPubMed
Wong, A, Filimonov, A, Lee, YJ, Hsueh, WD, Baredes, S, Liu, JK et al. The impact of resident and fellow Participation in Transsphenoidal Pituitary Surgery. Laryngoscope 2018;128:2707–13CrossRefGoogle ScholarPubMed
Muelleman, T, Shew, M, Muelleman, RJ, Villwock, M, Sykes, KJ, Staecker, H et al. Impact of resident participation on operative time and outcomes in otologic surgery. Otolaryngol Head Neck Surg 2018; 158:151–4CrossRefGoogle ScholarPubMed
Kshirsagar, RS, Chandy, Z, Mahboubi, H, Verma, SP. Does resident involvement in thyroid surgery lead to increased postoperative complications? Laryngoscope 2017;127:1242–6CrossRefGoogle ScholarPubMed
Hennessey, PT, Francis, HW, Gourin, CG. Is there a “July effect” for head and neck cancer surgery? Laryngoscope 2013;123:1889–95CrossRefGoogle Scholar
Ehlert, BA, Nelson, JT, Goettler, CE, Parker, FM, Bogey, WM, Powell, CS et al. Examining the myth of the “July Phenomenon” in surgical patients. Surgery 2011;150:332–8CrossRefGoogle Scholar
Ford, AA, Bateman, BT, Simpson, LL, Ratan, RB. Nationwide data confirms absence of ‘July phenomenon’ in obstetrics: it's safe to deliver in July. J Perinatol 2007;27:73–6CrossRefGoogle ScholarPubMed
Watkins, AA, Bliss, LA, Cameron, DB, Eskander, MF, Tseng, JF, Kent, TS. Deconstructing the “July effect” in operative outcomes: a national study. J Gastrointest Surg 2016;20:1012–19CrossRefGoogle ScholarPubMed
Highstead, RG, Johnson, LS, Street, JH 3rd, Trankiem, CT, Kennedy, SO, Sava, JA. July—as good a time as any to be injured. J Trauma 2009;67:1087–90Google Scholar
Lieber, BA, Appelboom, G, Taylor, BES, Malone, H, Agarwal, N, Connolly, ES. Assessment of the “July Effect”: outcomes after early resident transition in adult neurosurgery. J Neurosurg 2016;125:213–21CrossRefGoogle ScholarPubMed
Gagnier, JJ, Derosier, JM, Maratt, JD, Hake, ME, Bagian, JP. Development, implementation and evaluation of a patient handoff tool to improve safety in orthopaedic surgery. Int J Qual Health Care 2016;28:363–70CrossRefGoogle ScholarPubMed
Murray, N, Valdez, TA, Hughes, AL, Kavanagh, KR. Teaching a tracheotomy handoff tool to pediatric first responders. Int J Pediatr Otorhinolaryngol 2018;114:120–3CrossRefGoogle ScholarPubMed
Mukdad, L, Goel, AN, Nasser, HB, St John, MA. Understanding nationwide readmissions after parotidectomy. Laryngoscope 2020;130:1212–17CrossRefGoogle ScholarPubMed
Hatch, JL, Bauschard, MJ, Nguyen, SA, Lambert, PR, Meyer, TA, McRackan, TR. Does hospital volume affect outcomes in patients undergoing vestibular schwannoma surgery? Otol Neurotol 2018;39:481–7CrossRefGoogle ScholarPubMed
Rubin, SJ, Wu, KY, Kirke, DN, Ezzat, WH, Truong, MT, Salama, AR et al. Head and neck cancer complications in the geriatric population based on hospital case volume. Ear Nose Throat J 2021;100:62–8CrossRefGoogle ScholarPubMed
Cheung, MC, Koniaris, LG, Perez, EA, Molina, MA, Goodwin, JW, Salloum, RM. Impact of hospital volume on surgical outcome for head and neck cancer. Ann Surg Oncol 2009;16:1001–9CrossRefGoogle ScholarPubMed
Vieira, BL, Hernandez, DJ, Qin, C, Smith, SS, Kim, JYS, Dutra, JC. The impact of resident involvement on otolaryngology surgical outcomes. Laryngoscope 2016;126:602–7CrossRefGoogle ScholarPubMed