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Trends in surgical use and associated patient outcomes in the treatment of acoustic neuroma.

Publication ,  Journal Article
Patel, S; Nuño, M; Mukherjee, D; Nosova, K; Lad, SP; Boakye, M; Black, KL; Patil, CG
Published in: World Neurosurg
2013

OBJECTIVE: To investigate recent trends in surgical volume and associated patient outcomes in the treatment of acoustic neuromas. METHODS: A retrospective analysis was performed using the Nationwide Inpatient Sample database from 2000-2007; cases from 2005 were excluded because of coding inconsistencies. Univariate and multivariate analyses were used to describe surgical trends and analyze inpatient outcomes. RESULTS: Among 14,928 patients studied, 87.1% were treated at large (based on number of beds) hospitals. Cases at these hospitals declined progressively from 2054 to 1467 cases (a 28.6% decrease) from 2000-2007; a 40.8% (178 cases per year, R(2) = 0.73) reduction in surgeries was observed from 2001-2007. Although mortality remained steady at 0.3%, nonroutine discharge (increase from 10.9% to 19.1%) and complication rates (increase from 21.5% to 23.3%) increased in recent years. Patients without private insurance had an increased risk of nonroutine discharge (odds ratio [OR] 1.7, P = 0.0033; OR 1.5, P = 0.0382), and patients with more comorbidities had an increased risk of complications (OR 1.8, P < 0.0001; OR 1.5, P < 0.0001). High surgical caseload reduced nonroutine discharge by 30% (OR 0.7, P < 0.0001) and complications by 10% (OR 0.9, P < 0.0281). CONCLUSIONS: A 41%, or 178 cases per year, reduction in surgical excision of acoustic neuroma cases was observed during the period 2001-2007. A possible explanation for this trend includes increased use of stereotactic radiosurgery. Nonroutine discharge and complications after surgical excision have increased perhaps because of surgery being used for larger tumors.

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Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

2013

Volume

80

Issue

1-2

Start / End Page

142 / 147

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Risk
  • Radiosurgery
  • Postoperative Complications
  • Neurosurgical Procedures
  • Neuroma, Acoustic
  • Middle Aged
  • Male
  • International Classification of Diseases
  • Insurance, Health
 

Citation

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Chicago
ICMJE
MLA
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Patel, S., Nuño, M., Mukherjee, D., Nosova, K., Lad, S. P., Boakye, M., … Patil, C. G. (2013). Trends in surgical use and associated patient outcomes in the treatment of acoustic neuroma. World Neurosurg, 80(1–2), 142–147. https://doi.org/10.1016/j.wneu.2012.06.029
Patel, Sahil, Miriam Nuño, Debraj Mukherjee, Kristin Nosova, Shivanand P. Lad, Maxwell Boakye, Keith L. Black, and Chirag G. Patil. “Trends in surgical use and associated patient outcomes in the treatment of acoustic neuroma.World Neurosurg 80, no. 1–2 (2013): 142–47. https://doi.org/10.1016/j.wneu.2012.06.029.
Patel S, Nuño M, Mukherjee D, Nosova K, Lad SP, Boakye M, et al. Trends in surgical use and associated patient outcomes in the treatment of acoustic neuroma. World Neurosurg. 2013;80(1–2):142–7.
Patel, Sahil, et al. “Trends in surgical use and associated patient outcomes in the treatment of acoustic neuroma.World Neurosurg, vol. 80, no. 1–2, 2013, pp. 142–47. Pubmed, doi:10.1016/j.wneu.2012.06.029.
Patel S, Nuño M, Mukherjee D, Nosova K, Lad SP, Boakye M, Black KL, Patil CG. Trends in surgical use and associated patient outcomes in the treatment of acoustic neuroma. World Neurosurg. 2013;80(1–2):142–147.
Journal cover image

Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

2013

Volume

80

Issue

1-2

Start / End Page

142 / 147

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Risk
  • Radiosurgery
  • Postoperative Complications
  • Neurosurgical Procedures
  • Neuroma, Acoustic
  • Middle Aged
  • Male
  • International Classification of Diseases
  • Insurance, Health