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Kim HS, Park CW, Yoo CJ, et al. Impact of admission month on outcomes in spontaneous subarachnoid hemorrhage: evidence against the march effect. J Cerebrovasc Endovasc Neurosurg. 2013;15(2):67-75doi: 10.7461/jcen.2013.15.2.67.
Kim, H. S., Park, C. W., Yoo, C. J., Kim, E. Y., Kim, Y. B., & Kim, W. K. (2013). Impact of admission month on outcomes in spontaneous subarachnoid hemorrhage: evidence against the march effect. Journal of cerebrovascular and endovascular neurosurgery, 15(2), 67-75. https://doi.org/10.7461/jcen.2013.15.2.67
Kim, Hyun Su, et al. "Impact of admission month on outcomes in spontaneous subarachnoid hemorrhage: evidence against the march effect." Journal of cerebrovascular and endovascular neurosurgery vol. 15,2 (2013): 67-75. doi: https://doi.org/10.7461/jcen.2013.15.2.67
Kim HS, Park CW, Yoo CJ, Kim EY, Kim YB, Kim WK. Impact of admission month on outcomes in spontaneous subarachnoid hemorrhage: evidence against the march effect. J Cerebrovasc Endovasc Neurosurg. 2013 Jun;15(2):67-75. doi: 10.7461/jcen.2013.15.2.67. Epub 2013 Jun 28. PMID: 23844350; PMCID: PMC3704997.
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J Cerebrovasc Endovasc Neurosurg. 2013 Jun;15(2):67-75. doi: 10.7461/jcen.2013.15.2.67. Epub 2013 Jun 28.

Impact of admission month on outcomes in spontaneous subarachnoid hemorrhage: evidence against the march effect.

Journal of cerebrovascular and endovascular neurosurgery

Hyun Su Kim, Cheol Wan Park, Chan Jong Yoo, Eun Young Kim, Young Bo Kim, Woo Kyung Kim

Affiliations

  1. Department of Neurosurgery, Gil Medical Center, Incheon, Gachon University, Republic of Korea.

PMID: 23844350 PMCID: PMC3704997 DOI: 10.7461/jcen.2013.15.2.67

Abstract

OBJECTIVE: We attempted to identify the presence of a so called 'March effect (or phenomenon)' (which had long been known as a 'July effect' in western countries), a transient increase in adverse outcomes during an unskilled period for new interns and residents in a teaching hospital, among a cohort of patients with spontaneous subarachnoid hemorrhage (sSAH).

METHODS: A total of 455 consecutive patients with sSAH from our department database from 2008 to 2010 were enrolled retrospectively and the admission month, patient demographics and clinical characteristics, treatment modalities and discharge outcomes were analyzed. Multivariate regression analysis was used to determine whether unfavorable discharge and in-hospital mortality showed a significant increase during the unskilled months for new interns and residents (from March to May) in a pattern suggestive of a "March effect".

RESULTS: Among 455 patients with sSAH, 113 patients were treated during the unskilled period (from March to May) and the remaining 342 patients were treated during the skilled period (from June until February of the next year). No statistically significant difference in demographics and clinical characteristics was observed between patients treated during these periods. In addition, the mortality and unfavorable discharge rates of the un-skilled period were 16.8% and 29.7% and those of the skilled period were 15.5% and 27.2%, respectively. However, no statistically significant difference was observed between them.

CONCLUSIONS: Findings of our study suggest that there was no 'March effect' on the mortality rate and unfavorable discharge rate among patients with sSAH in our hospital during the study period.

Keywords: July effect; March effect; Mortality rate; Spontaneous subarachnoid hemorrhage; Teaching hospital

References

  1. Obstet Gynecol. 2003 Nov;102(5 Pt 1):1080-4 - PubMed
  2. Med Care. 1993 Jan;31(1):73-83 - PubMed
  3. Neurosurgery. 2004 Apr;54(4):925-31; discussion 931-3 - PubMed
  4. N Engl J Med. 2004 Oct 28;351(18):1829-37 - PubMed
  5. Patient Saf Surg. 2009 Feb 20;3(1):3 - PubMed
  6. Arch Intern Med. 1989 Apr;149(4):765-8 - PubMed
  7. Health Aff (Millwood). 1988 Spring;7(1):62-78 - PubMed
  8. Crit Care Med. 2009 Feb;37(2):432-40 - PubMed
  9. J Neurosurg. 2006 Sep;105(3 Suppl):169-76 - PubMed
  10. Ann Surg. 2007 Sep;246(3):456-62; discussion 463-5 - PubMed
  11. Am J Health Syst Pharm. 2004 Jun 1;61(11):1130-4 - PubMed
  12. J Gen Intern Med. 2003 Aug;18(8):639-45 - PubMed
  13. J Gen Intern Med. 2010 Aug;25(8):774-9 - PubMed
  14. N Engl J Med. 2005 Jan 13;352(2):125-34 - PubMed
  15. Spine (Phila Pa 1976). 2002 May 1;27(9):962-5 - PubMed
  16. BMJ. 1994 Dec 24-31;309(6970):1690 - PubMed
  17. J Neurosurg. 2006 Sep;105(3 Suppl):165-8 - PubMed
  18. Neurol Res. 2002;24 Suppl 1:S47-57 - PubMed
  19. JAMA. 2004 Feb 18;291(7):866-9 - PubMed
  20. Crit Care Med. 2004 May;32(5):1161-5 - PubMed
  21. JAMA. 1990 Feb 16;263(7):953-7 - PubMed
  22. J Trauma. 2010 Jan;68(1):19-22 - PubMed
  23. Mo Med. 2004 Mar-Apr;101(2):128-31 - PubMed
  24. J Neurosurg. 2012 Jan;116(1):157-63 - PubMed
  25. N Engl J Med. 2004 Oct 28;351(18):1838-48 - PubMed
  26. Surgery. 2001 Aug;130(2):346-53 - PubMed
  27. Stroke. 2009 Mar;40(3):994-1025 - PubMed
  28. Am J Med Qual. 1995 Spring;10(1):14-7 - PubMed

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