Introduction: With limited data available on effect of hospital case volume on outcomes following surgical resection of intra-dural spine tumors, we attempted to quantify these associations using a large population based database.
Methods: A retrospective analysis of patients undergoing intra-dural spine tumor resection in the United States between 2002-2011 using the NIS database was performed.
Based on the frequency of surgeries performed during the study period, hospitals were classified into equal halves based on median quartiles. A hospital was labelled as a low volume center (LVC) if it performed <14 and a high volume center (HVC) if it performed =14 surgeries during the study period.
Results: Overall, 18,297 patients underwent surgical resection for intra-dural spine tumors in the United States across 774 US hospitals. The mean age of the cohort was 56.56 ± 16.25 years and 63 % were females. In a binary multivariate logistic regression model, the inpatients post-operative risks were significantly lower for unfavorable discharge (OR: 0.87; 95% CI: 0.78-0.97;p=0.01), prolonged LOS (OR: 0.71; 95% CI: 0.64-0.79;p<0.0001), high-end hospital charges (OR: 0.67; 95% CI: 0.60-0.75;p<0.0001), neurologic complications (OR: 0.33; 95% CI: 0.26-0.43;p<0.0001), venous thromboembolism (OR: 0.75; 95% CI: 0.58-0.96;p=0.021),wound infections (OR: 0.51; 95% CI: 0.30-0.90;p=0.019), wound complications (OR: 0.66; 95% CI: 0.45-0.96;p=0.028), and gastro-intestinal complications (OR: 0.66; 95% CI: 0.47-0.92;p=0.016) in HVCs with reference to LVCs
Conclusions: NIS-database analysis shows statistical evidence of better post-operative outcomes in HVCs with respect to LVCs.
Patient Care: Our analysis quantifies the risks/odds of unfavorable outcomes in hospital volume centers.
Learning Objectives: The participants would be able to identify the effect of hospital case volumes on outcomes for resection of intra-dural spine tumors