Patterns and outcomes of neurosurgery in England over a five-year period: A national retrospective cohort study

Wahba, Adam J; Cromwell, David; Hutchinson, Peter J.; Mathew, Ryan; Phillips, Nick

doi:10.1016/j.ijsu.2022.106256

Cited by 4 publications

(3 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Moreover, neurosurgery poses inevitable/unavoidable dangers to patients, such as intracranial infection 3) , postoperative pulmonary complications 1) , rebleeding 5) , or increased abdominal pressure 6) . One in four patients underwent additional procedures following non-elective surgery 29) , and the mortality rate of patients who underwent nonelective neurosurgery was higher 29) . Patients supported by equipment such as mechanical ventilators, ECMO, and CRRT are in a major organ failure stage with unstable hemodynam- ics and are probably associated with prolonged hospitalization and higher in-hospital mortality 12,22) .…”

Section: Discussionmentioning

confidence: 99%

Trend of Intensive Care Unit Admission in Neurology-Neurosurgery Adult Patients in South Korea : A Nationwide Population-Based Cohort Study

Kim,

Oh,

Song

et al. 2024

J Korean Neurosurg Soc

View full text Add to dashboard Cite

Objective : We aimed to examine trends in critically ill neurology-neurosurgery (NNS) patients who were admitted to the intensive care unit (ICU) in South Korea and identify risk factors for in-hospital mortality after ICU admission in NNS patients.Methods : This nationwide population-based retrospective cohort study enrolled adult NNS adult patients admitted to the ICU from 2010 to 2019 extracted from the National Health Insurance Service in South Korea. The critically ill NNS patients were defined as those whose main admission departments were neurology or neurosurgery at ICU admission. The number of ICU admission, age, and total cost for hospitalization from 2010 to 2019 in critically ill NNS patients were examined as trend information. Moreover, multivariable logistic regression modeling was used to identify risk factors for in-hospital mortality among critically ill NNS patients.Results : We included 845474 ICU admission cases for 679376 critically ill NNS patients in South Korea between January 1, 2010 to December 31, 2019. The total number of ICU admissions among NNS patients was 79522 in 2010, which increased to 91502 in 2019. The mean age rose from 62.8 years (standard deviation [SD], 15.6) in 2010 to 66.6 years (SD, 15.2) in 2019, and the average total cost for hospitalization per each patient consistently increased from 6206.1 USD (SD, 5218.5) in 2010 to 10745.4 USD (SD, 10917.4) in 2019. In-hospital mortality occurred in 75455 patients (8.9%). Risk factors strongly associated with increased in-hospital mortality were the usage of mechanical ventilator (adjusted odds ratio [aOR], 19.83; 95% confidence interval [CI], 19.42–20.26; p<0.001), extracorporeal membrane oxygenation (aOR, 3.49; 95% CI, 2.42–5.02; p<0.001), and continuous renal replacement therapy (aOR, 6.47; 95% CI, 6.02–6.96; p<0.001). In addition, direct admission to ICU from the emergency room (aOR, 1.38; 95% CI, 1.36–1.41; p<0.001) and brain cancer as the main diagnosis (aOR, 1.30; 95% CI, 1.22–1.39; p<0.001) are also potential risk factors for increased in-hospital mortality.Conclusion : In South Korea, the number of ICU admissions increased among critically ill NNS patients from 2010 to 2019. The average age and total costs for hospitalization also increased. Some potential risk factors are found to increase in-hospital mortality among critically ill NNS patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Trend of Intensive Care Unit Admission in Neurology-Neurosurgery Adult Patients in South Korea : A Nationwide Population-Based Cohort Study

Kim,

Oh,

Song

et al. 2024

J Korean Neurosurg Soc

View full text Add to dashboard Cite

show abstract

“…These challenges have manifested sharp declines in operating capacity and neurosurgical referrals, with a further pronounced decrease in bed availability and a concerning trend of patients avoiding healthcare services. [ 28 ] Each of these factors plays a role in altering the LOS, and given the link between prolonged LOS and increased mortality rates, disease burden, and hospital expenditure, identifying temporal trends in the LOS can allow better management of hospital resources and improve patient outcomes. [ 10 ] The importance of understanding such trends is more pertinent than ever following the pandemic, as neurosurgical centers continue to tackle increased waiting lists as well as higher referral volumes and operative procedures, thus working at a higher capacity than usual.…”

Section: Discussionmentioning

confidence: 99%

“…[ 10 ] The importance of understanding such trends is more pertinent than ever following the pandemic, as neurosurgical centers continue to tackle increased waiting lists as well as higher referral volumes and operative procedures, thus working at a higher capacity than usual. [ 28 ] Our present study analyzed how the frequency of neurosurgical operations (day case and elective) and LOS has changed over a 10-year period from 2012 to 2022 at a tertiary neurosurgical center in the UK. It is the first-ever study from a public healthcare system such as the UK to have analyzed how operative neurosurgery has evolved over a 10-year period in a high-volume tertiary center and how COVID-19 has affected this over the past three years.…”

Section: Discussionmentioning

confidence: 99%

Temporal trends in neurosurgical volume and length of stay in a public healthcare system: A decade in review with a focus on the COVID-19 pandemic

Snowdon,

Biswas,

Almansoor

et al. 2023

Surgical Neurology International

View full text Add to dashboard Cite

Background: Over the past decade, neurosurgical interventions have experienced changes in operative frequency and postoperative length of stay (LOS), with the recent COVID-19 pandemic significantly impacting these metrics. Evaluating these trends in a tertiary National Health Service center provides insights into the impact of surgical practices and health policy on LOS and is essential for optimizing healthcare management decisions. Methods: This was a single tertiary center retrospective case series analysis of neurosurgical procedures from 2012 to 2022. Factors including procedure type, admission urgency, and LOS were extracted from a prospectively maintained database. Six subspecialties were analyzed: Spine, Neuro-oncology, Skull base (SB), Functional, Cerebrospinal fluid (CSF), and Peripheral nerve (PN). Mann-Kendall temporal trend test and exploratory data analysis were performed. Results: 19,237 elective and day case operations were analyzed. Of the 6 sub-specialties, spine, neuro-oncology, SB, and CSF procedures all showed a significant trend toward decreasing frequency. A shift toward day case over elective procedures was evident, especially in spine (P < 0.001), SB (tau = 0.733, P = 0.0042), functional (tau = 0.156, P = 0.0016), and PN surgeries (P < 0.005). Over the last decade, decreasing LOS was observed for neuro-oncology (tau = −0.648, P = 0.0077), SB (tau = −0.382, P = 0.012), and functional operations, a trend which remained consistent during the COVID-19 pandemic (P = 0.01). Spine remained constant across the decade while PN demonstrated a trend toward increasing LOS. Conclusion: Most subspecialties demonstrate a decreasing LOS coupled with a shift toward day case procedures, potentially attributable to improvements in surgical techniques, less invasive approaches, and increased pressure on beds. Setting up extra dedicated day case theaters could help deal with the backlog of procedures, particularly with regard to the impact of COVID-19.

show abstract

The volume-outcome relationship for endoscopic transsphenoidal pituitary surgery for benign neoplasm: analysis of an administrative dataset for England

Gray¹,

Navaratnam

Rennie

et al. 2023

British Journal of Neurosurgery

View full text Add to dashboard Cite

Patterns and outcomes of neurosurgery in England over a five-year period: A national retrospective cohort study

Cited by 4 publications

References 30 publications

Trend of Intensive Care Unit Admission in Neurology-Neurosurgery Adult Patients in South Korea : A Nationwide Population-Based Cohort Study

Trend of Intensive Care Unit Admission in Neurology-Neurosurgery Adult Patients in South Korea : A Nationwide Population-Based Cohort Study

Temporal trends in neurosurgical volume and length of stay in a public healthcare system: A decade in review with a focus on the COVID-19 pandemic

The volume-outcome relationship for endoscopic transsphenoidal pituitary surgery for benign neoplasm: analysis of an administrative dataset for England

Contact Info

Product

Resources

About