Does time matter? Impact of residency start month on EGS outcome in Pakistan

Authors

Komal Abdul Rahim, Aga Khan UniversityFollow
Kantesh Kumar, Aga Khan UniversityFollow
Aiman Arif, Aga Khan UniversityFollow
Kinzah Razzak Ghazi, Aga Khan UniversityFollow
Saad Bin Zafar Mahmood, Aga Khan UniversityFollow
Saqib Kamran Bakhshi, Aga Khan UniversityFollow
Mushayda Ali, Aga Khan University
Zainab Samad, Aga Khan UniversityFollow
Adil H. Haider, Aga Khan UniversityFollow

Document Type

Article

Department

Community Health Sciences; Center of Excellence for Trauma and Emergencies; Medical College Pakistan; Medicine; Neurosurgery

Abstract

Background: Trainee turnover in hospitals with induction of new, less experienced residents and changeover in the clinical teams has been considered an essential factor for increased morbidity and mortality. In high-income countries (HICs), this is known as the July effect-the time for new inductees. We aim to study the January effect (time of new inductees in our setting) and patient outcomes in an Emergency General Surgery (EGS) cohort.
Methods: We used secondary data from adult patients with EGS diagnosis from a tertiary care center in Pakistan (2010-2019). The outcomes of interest were severe adverse events (SAEs), inpatient mortality, length of stay [LOS], and failure to rescue (FTR). Multiple logistic and linear regressions was performed to assess their association.
Results: Of the 32,280 patients analyzed, 7.94% were admitted in January. There was significantly higher elective admission (61.06% vs. 53.51%) and surgical interventions (74.80% vs. 72.92%) in January compared to other months. Inpatient mortality, SAEs, FTRs, and LOS did not significantly differ between the two groups. Multivariable analysis showed no significant association of January admission with SAE (AOR 1.06; 95% CI 0.97-1.16), inpatient mortality (AOR 1.09; 95% CI 0.83-1.43), FTR (AOR 1.04; 95% CI 0.78-1.38), and LOS (β 0.12; 95% CI -0.05-0.29).
Conclusion: The results of the study, which has no evidence of the January effect for EGS patients, suggest that this effect is not universally applicable, necessitating context-specific evaluation to understand the temporal trends in the overall health outcomes of the admitted patients.

Comments

Volume, issue and pagination are not p[provided by the author/publisher.

Publication (Name of Journal)

World Journal of Surgery

DOI

10.1002/wjs.70049

Recommended Citation

Rahim, K. A., Kumar, K., Arif, A., Ghazi, K. R., Mahmood, S. Z., Bakhshi, S. K., Ali, M., Samad, Z., Haider, A. H. (2025). Does time matter? Impact of residency start month on EGS outcome in Pakistan. World Journal of Surgery.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_chs_chs/1229