Evidence map›Paper›PMID 31129956›Full record

ArticleClinical endoscopy2019

A Nationwide Assessment of the "July Effect" and Predictors of Post-Endoscopic Retrograde Cholangiopancreatography Sepsis at Urban Teaching Hospitals in the United States.

Rupak Desai, Upenkumar Patel, Shreyans Doshi, Dipen Zalavadia, Wardah Siddiq, Hitanshu Dave, Mohammad Bilal, Vikas Khullar, Hemant Goyal, Madhav Desai and 1 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical endoscopy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.0field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 10 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 11 institutions in 1 country.

Rupak DesaiAtlanta VA Medical Center, Decatur, GA, USA.
Upenkumar PatelDepartment of Internal Medicine, Nassau University Medical Center, East Meadow, NY, USA.
Shreyans DoshiDepartment of Internal Medicine, College of Medicine/Hospital Corporation of America Graduate Medicine Education Consortium, University of Central Florida, Gainesville, FL, USA.
Dipen ZalavadiaDepartment of Internal Medicine, The Wright Center for Graduate Medical Education, Scranton, PA, USA.
Wardah SiddiqBeth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Hitanshu DaveDepartment of Internal Medicine, Jersey Shore University Medical Center, Neptune, NJ, USA.
Mohammad BilalDivision of Gastroenterology & Hepatology, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA.
Vikas KhullarDivision of Gastroenterology, Department of Internal Medicine, University of Florida, Gainesville, FL, USA.
Hemant GoyalDepartment of Internal Medicine, Mercer University School of Medicine, Macon, GA, USA.
Madhav DesaiDivision of Gastroenterology & Hepatology, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, MO, USA.
Nihar ShahDivision of Gastroenterology, Department of Internal Medicine, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA.
Atlanta VA Medical Center · USBeth Israel Deaconess Medical Center · USHCA Healthcare · USJersey Shore University Medical Center · USMarshall University · USMercer University · USNassau University Medical Center · USThe University of Texas Medical Branch at Galveston · USThe Wright Center for Graduate Medical Education · USUniversity of Florida · USUniversity of Kansas Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

aimsTo analyze the incidence of post-endoscopic retrograde cholangiopancreatography (ERCP) sepsis in the early (July to September) and later (October to June) academic months to assess the "July effect".

methodsThe National Inpatient Sample (2010-2014) was used to identify ERCP-related adult hospitalizations at urban teaching hospitals by applying relevant procedure codes from the International Classification of Diseases, 9th revision, Clinical Modification. Post-ERCP outcomes were compared between the early and later academic months. A multivariate analysis was performed to evaluate the odds of post-ERCP sepsis and its predictors.

resultsOf 481,193 ERCP procedures carried out at urban teaching hospitals, 124,934 were performed during the early academic months. The demographics were comparable for ERCP procedures performed during the early and later academic months. A higher incidence (9.4% vs. 8.8%, p<0.001) and odds (odds ratio [OR], 1.07) of post-ERCP sepsis were observed in ERCP performed during the early academic months. The in-hospital mortality rate (7% vs. 7.5%, p=0.072), length of stay, and total hospital charges in patients with post-ERCP sepsis were also equivalent between the 2 time points. Pre-ERCP cholangitis (OR, 3.20) and post-ERCP complications such as cholangitis (OR, 6.27), perforation (OR, 3.93), and hemorrhage (OR, 1.42) were significant predictors of higher post-ERCP sepsis in procedures performed during the early academic months.

conclusionThe July effect was present in the incidence of post-ERCP sepsis, and academic programs should take into consideration the predictors of post-ERCP sepsis to lower health-care burden.

Indexed as

Endoscopic retrograde cholangiopancreatographyLength of stayMortalityPancreatitisSepsis

Identifiers

PMID31129956
PMCPMC6785412
OpenAlexW2947744106

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.