Study casts doubt on 'July effect' in heart surgeries

Heart surgery patients do not demonstrate worse outcomes in July when medical school graduates start their residencies, according to a study published in The Annals of Thoracic Surgery.

To assess whether the "July effect" is a real phenomenon, researchers used data from the National Inpatient Sample to examine outcomes for patients who underwent one of the following procedures at teaching and nonteaching hospitals between 2012-14:

  • Coronary artery bypass grafting
  • Surgical aortic valve replacement
  • Mitral valve repair or replacement
  • Isolated thoracic aortic aneurysm

Researchers assessed patients' in-hospital mortality and complication rates in relation to the month and academic quarter the procedure was done in. They found risk-adjusted mortality rates did not vary based on when the procedure was performed. Teaching hospitals also demonstrated equivalent — and sometimes better — patient outcomes for heart surgeries.

"The July effect is not evident for cardiac surgery despite preexisting notions," researchers concluded. "These findings highlight the pivotal role of hospital support systems to ensure the safe transition of resident classes without compromising on patient outcomes."

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