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  • Drivers of Unfavorable Outcomes Following Resection of Benign Intradural Spine Tumors and the Effect of Hospital Volume on Outcomes: An Analysis of 18,297 Patients Across 774 US Hospitals Using the Na

    Final Number:

    Piyush Kalakoti MD; Symeon Missios MD; Anil Nanda MD, FACS

    Study Design:

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2015 Annual Meeting

    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


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