An Analysis of Manuscript Trajectories Following Journal Editorial Decisions

BACKGROUND: Manuscript rejection is inevitable in academic publishing. With rising submission volumes, pre-peer review rejection (“desk rejection”) is increasingly used as a pragmatic filter to focus on papers more likely to be published. Temporal trends, geographic disparities, and post-rejection outcomes are essential to inform editorial practices, author expectations, and assess whether pre-peer review decisions are justified. METHODS: We retrospectively analyzed all original research manuscripts submitted to Anesthesia & Analgesia ( A&A ) from January 2021 to December 2024. Outcomes were pre-peer review rejection, post-peer review rejection, and acceptance. Predictors included submission year, corresponding author country, and author submission history. Multivariable logistic regression models estimated adjusted odds ratios (aOR). To track rejected manuscripts to publication elsewhere, we developed a hybrid automated–manual tracking system querying PubMed and CrossRef Application Programming Interface (APIs) with title matching and author verification, followed by systematic manual verification. Destination journals were classified by pay-to-publish status. RESULTS: Of 3881 manuscripts, 3317 of 3881 (85.5%) were rejected; 1463 (37.7%) received pre-peer review rejection, 1854 (47.8%) post-peer review rejection. Median (interquartile range [IQR]) time to rejection was 5 (3–9) days vs 29 (20–46) days for pre- and post-peer review rejection, respectively. Pre-peer review rejection doubled from 27.9% (2021) to 56.2% (2024), while post-peer review rejection fell from 56.6% to 34%. Manuscripts from upper- and lower-middle-income countries had greater odds of pre-peer review rejection versus high-income countries (aOR, 3.23; 95% CI, 2.79–3.75 and aOR, 3.75; 95% CI, 2.91–4.85; both P < .001) but lower post-peer review rejection odds. Publication tracking achieved 86.5% success (2868/3317). Pre-peer review rejected manuscripts published faster than post-peer review rejected ones (median [IQR] 294 [190–461] vs 345 [220–520] days; P < .001). Of the 2868 manuscripts published elsewhere, 78% of those in journals with an impact factor (IF) appeared in journals with an IF below that of A&A (4.0) and 939 (32.7%) appeared in pay-to-publish venues. CONCLUSIONS: Editorial decision-making at A&A shifted markedly toward earlier decision, with pre-peer review rejection doubled while post-peer review rejection halved over 4 years. Geographic disparities emerged at the pre-peer review stage, suggesting earlier filtering of manuscripts from middle-income countries. Although 86.5% of rejected manuscripts were published elsewhere, 78% of those in IF-indexed journals appeared in journals with a lower IF, and 32.7% overall appeared in pay-to-publish venues.