Investigator University of Pennsylvania, United States
Introduction: The phrase “July Residents” is widely used throughout the medical community to describe the new influx of inexperienced residents in the month of July. It is thought that during this month patients are at a higher risk of harm from these providers. Our study aimed to evaluate whether failed intubations in the month of July caused increase mortality, length of stay, or total charges for patients compared to that of other months in urban teaching hospitals.
Methods: The National Inpatient Sample (NIS) database (2016-2020) was analyzed to identify adults with the ICD-10 diagnostic/procedural codes for failed or difficult intubation. Multivariate logistic regression analysis was used to obtain the odds ratios (OR) of inpatient mortality. Multivariate linear regression was used to determine the average length of hospital stay (LOS) and average total hospitalization charges (TOTCHG) with respect to month of the year. Weighted analysis using Stata 17 MP was performed.
Results: A total of 4,459 adult patients were identified to have failed intubation, of which 618 died.
There was no statistically significant difference in mortality, LOS, and TOTCHG in July compared to non-July months when controlling for age, race, gender, and Charlson Comorbidity Index (CCI).
Conclusions: When controlling for age, race, gender, and Charlson Comorbidity Index of patients and comparing the mortality, length of stay, and total hospital costs of patients with failed intubation in July, our study noticed no significant difference when compared to that of non-July months. So although there may be more inexperienced physicians during the month of July, outcomes in patients that have had failed intubations are unchanged. Further studies are needed to evaluate the LOS, mortality, and TOTCHG in other clinical settings in order to reduce the negative stigma surrounding “July residents”.
