July--as good a time as any to be injured.
BACKGROUND
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.


METHODS
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.


RESULTS
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).


CONCLUSIONS
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.
Highstead
R Grant
RG
Washington Hospital Center, Washington, DC, USA.
Johnson
Laura S
LS
Johnson
Laura C
LC
Street
James H
JH
Trankiem
Christine T
CT
Kennedy
Susan O
SO
Sava
Jack A
JA
D000328:Adult; D004219:District of Columbia / Q000453:epidemiology; D005260:Female; D013502:General Surgery / Q000592:standards; D006784:Hospitals, Teaching / Q000592:standards*; D006801:Humans; D007396:Internship and Residency; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011785:Quality Assurance, Health Care; D011787:Quality of Health Care; D012042:Registries; D012189:Retrospective Studies; D012621:Seasons; D014947:Wounds and Injuries / Q000453:epidemiology / Q000601:surgery*; D055815:Young Adult