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July Residency Influx Doesn't Impact Spinal Surgery Outcomes

Similar mortality, implant reactions, and post-op wound dehiscence after spine surgery

FRIDAY, Feb. 1 (HealthDay News) -- The July influx of new residents has a minimal effect on peri-procedural outcomes for patients undergoing spinal surgery, according to a study published online Jan. 29 in the Journal of Neurosurgery: Spine.

Jennifer S. McDonald, Ph.D., from the Mayo Clinic in Rochester, Minn., and colleagues analyzed data from the Nationwide Inpatient Sample to identify all cases of spinal surgery (2001 to 2008) and compare outcomes among patients undergoing surgery in July compared with other months.

The researchers found that, for patients who were admitted to teaching hospitals in July for spinal surgery, the likelihood of in-hospital mortality, reaction to implanted device/instrumentation, and postoperative wound dehiscence was not significantly different than for patients admitted in other months. July admittance to teaching hospitals was associated with a significantly higher likelihood of discharge to a long-term care facility (odds ratio, 1.03; P = 0.0467) and postoperative infection (odds ratio, 1.11; P = 0.0341), compared with other months, although incidence rates were similar irrespective of the month of admission. There was also a similar likelihood of all outcomes for higher-risk patients, regardless of admission month.

"In conclusion, this study of nationwide hospitalizations over an eight-year period indicates that the influx of new residents and fellows in July has a negligible effect on peri-procedural outcomes following spinal surgery," the authors write.

Abstract (http://thejns.org/doi/full/10.3171/2012.12.SPINE12300#abstract )Full Text (http://thejns.org/doi/full/10.3171/2012.12.SPINE12300 )