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HRS survey respondents support the concept of CIED reuse for patients in LMICs who cannot afford new devices. Studies are needed to demonstrate the clinical efficacy and safety of this practice and to identify potential barriers to adoption among physicians.

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CIEDs can be cleaned and sterilized according to a standardized protocol achieving a 12-log reduction of inoculated product, resulting in sterility assurance level of 10.

The highest volume trends in operative neurosurgery are for spinal fusion (increasing at a rate of approximately 12,000 procedures/y), craniotomy for tumors and other purposes (increasing at a rate of approximately 2,700 procedures/y), and a decrease in shunts (decreasing at a rate of approximately 3,000 per year). The data suggest that intracranial endovascular treatment remains relatively rare, but it is growing exponentially, and lengths of stay are increasing, whereas inhospital deaths are decreasing. The conclusions of this study are limited by the imprecise nature of the ICD-9-CM procedure codes, the categorization scheme we used, and by the sampling methods of the National Inpatient Sample.

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