{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:31:17Z","timestamp":1774225877446,"version":"3.50.1"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,4,9]],"date-time":"2019-04-09T00:00:00Z","timestamp":1554768000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>To evaluate the \u201cJuly effect,\u201d as a possible risk factor for perioperative complications in otolaryngology microvascular reconstruction during the transitional period in the academic calendar.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective database review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Microvascular reconstruction outcomes in the National Surgical Quality Improvement Program (2005\u20132016) database were compared between the first academic quarter (July\u2013September) to the last academic quarter (April\u2013June). The primary outcome was 30\u2010day morbidity, and secondary outcomes included 30\u2010day mortality, operative complications, or postoperative adverse events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 612 and 580 patients who underwent microvascular reconstruction during the first and last academic quarters, respectively. There was no significant difference between the 30\u2010day mortality between the first academic quarter (1.5%) and the last academic quarter (0.7%) (<jats:italic>P<\/jats:italic> = .194). There was no difference in 30\u2010day morbidity (47.9% vs. 49.5%, <jats:italic>P<\/jats:italic> = .586), operative complications (wound disruption, <jats:italic>P<\/jats:italic> = .151; bleeding, <jats:italic>P<\/jats:italic> = .526; operative time, <jats:italic>P<\/jats:italic> = .162), or postoperative adverse events (deep vein thrombosis, <jats:italic>P<\/jats:italic> = .460; pneumonia, <jats:italic>P<\/jats:italic> = .737; reintubation, <jats:italic>P<\/jats:italic> = .201; pulmonary embolism, <jats:italic>P<\/jats:italic> = .452; ventilation for &gt;48 hours, <jats:italic>P<\/jats:italic> = .769; acute renal failure, <jats:italic>P<\/jats:italic> = .500; urinary tract infection, <jats:italic>P<\/jats:italic> = .693; unplanned readmission, <jats:italic>P<\/jats:italic> = .202; and mean length of stay, <jats:italic>P<\/jats:italic> = .497).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There appears to be no July effect in microvascular reconstruction. Further studies should identify the mechanisms that preserve the safety of this operation year\u2010round for application to other areas of medicine who have observed the July effect.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>NA <jats:italic>Laryngoscope<\/jats:italic>, 130:893\u2013898, 2020<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.27988","type":"journal-article","created":{"date-parts":[[2019,4,10]],"date-time":"2019-04-10T06:43:35Z","timestamp":1554878615000},"page":"893-898","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The \u201cJuly effect\u201d: Outcomes in microvascular reconstruction during resident transitions"],"prefix":"10.1002","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1311-953X","authenticated-orcid":false,"given":"Amishav Y.","family":"Bresler","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Rutgers New Jersey Medical School  Newark New Jersey U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Bavier","sequence":"additional","affiliation":[{"name":"Rutgers New Jersey Medical School  Newark New Jersey U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1016-0070","authenticated-orcid":false,"given":"Evelyne","family":"Kalyoussef","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Rutgers New Jersey Medical School  Newark New Jersey U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soly","family":"Baredes","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Rutgers New Jersey Medical School  Newark New Jersey U.S.A"},{"name":"Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey Rutgers New Jersey Medical School  Newark New Jersey U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard Chan Woo","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Rutgers New Jersey Medical School  Newark New Jersey U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,4,9]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.1324"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1990.03450050031018"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.309.6970.1690"},{"key":"e_1_2_6_5_1","first-page":"606","article-title":"Hip fracture outcome: is there a \u201cJuly effect\u201d?","volume":"38","author":"Anderson K","year":"2009","journal-title":"Am J Orthop (Belle Mead 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