Abstract:
BACKGROUND:Length of stay beyond medical readiness (LOS-BMR) leads to increased expenses and higher morbidity related to hospital-acquired conditions. OBJECTIVE:To determine the proportion of admitted neurosurgical patients who have LOS-BMR and associated risk factors and costs. METHODS:We performed a prospective, cohort analysis of all neurosurgical patients admitted to our institution over 5 mo. LOS-BMR was assessed daily by the attending neurosurgeon and neuro-intensivist with a standardized criterion. Univariate and multivariate logistic regressions were performed. RESULTS:Of the 884 patients admitted, 229 (25.9%) had a LOS-BMR. The average LOS-BMR was 2.7 ± 3.1 d at an average daily cost of $9 148.28 ± $12 983.10, which resulted in a total cost of $2 076 659.32 over the 5-mo period. Patients with LOS-BMR were significantly more likely to be older and to have hemiplegia, dementia, liver disease, renal disease, and diabetes mellitus. Patients with a LOS-BMR were significantly more likely to be discharged to a subacute rehabilitation/skilled nursing facility (40.2% vs 4.1%) or an acute/inpatient rehabilitation facility (22.7% vs 1.7%, P < .0001). Patients with Medicare insurance were more likely to have a LOS-BMR, whereas patients with private insurance were less likely (P = .048). CONCLUSION:The most common reason for LOS-BMR was inefficient discharge of patients to rehabilitation and nursing facilities secondary to unavailability of beds at discharge locations, insurance clearance delays, and family-related issues.
journal_name
Neurosurgeryjournal_title
Neurosurgeryauthors
Linzey JR,Foshee R,Moriguchi F,Adapa AR,Koduri S,Kahn EN,Williamson CA,Sheehan K,Rajajee V,Thompson BG,Muraszko KM,Pandey ASdoi
10.1093/neuros/nyaa535subject
Has Abstractpub_date
2020-12-28 00:00:00eissn
0148-396Xissn
1524-4040pii
6054574pub_type
杂志文章相关文献
NEUROSURGERY文献大全abstract::: The Division of Neurosurgery at the University of Alabama at Birmingham was formally founded in 1954 under the leadership of James Garber Galbraith. The following 60 years would see neurosurgery at the forefront of the development of a nationally recognized medical center in the heart of Birmingham, Alabama. The Dep...
journal_title:Neurosurgery
pub_type: 传,历史文章,杂志文章
doi:10.1227/NEU.0000000000000464
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:Endovascular coil embolization of ruptured aneurysms is performed under general anesthesia at most centers for perceived improved image quality and patient safety. OBJECTIVE:To report the feasibility of and outcomes associated with endovascular treatment of subarachnoid hemorrhage (SAH) patients with ruptur...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0b013e31827b9183
更新日期:2013-02-01 00:00:00
abstract:OBJECTIVE:To assess the outcomes associated with C1-C2 transarticular screw fixation. METHODS:The clinical outcomes of 121 patients treated with posterior C1-C2 transarticular screws and wired posterior C1-C2 autologous bone struts were evaluated prospectively. Atlantoaxial instability was caused by rheumatoid arthrit...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199808000-00056
更新日期:1998-08-01 00:00:00
abstract::The authors have reported a clinical trial of an autologous cervical sympathetic ganglion transplanted into the brain of a parkinsonian patient. A 45-year-old woman presented with bradykinesia and a gait disturbance for 8 years under L-dopa treatment. The patient underwent stereotactic transplantation of the right ste...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199407000-00026
更新日期:1994-07-01 00:00:00
abstract::The history of spinal surgery is an important part of the spine-related sciences. The development of treatment strategies for spine-related disorders is acquired from the Western literature. In this article, an Eastern physician, Ibn Sina, who is known as Avicenna in the West, and his treatise, Al-Qanun fi al-Tibb (th...
journal_title:Neurosurgery
pub_type: 传,历史文章,杂志文章
doi:10.1227/01.neu.0000064811.30933.7f
更新日期:2003-06-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:Intraspinal solitary fibrous tumors, which are rare mesenchymal tumors, have previously been reported as case reports. We review our experience and, to our knowledge, the first small institutional series with respect to clinical presentation, diagnosis, surgical management, pathohistological an...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000163420.33635.9f
更新日期:2005-07-01 00:00:00
abstract::A case of a bacterial abscess developing in the sphenoid sinus 2 weeks after transsphenoidal surgery is presented. Although abscesses within the sella turcica have been reported as rare complications of transsphenoidal surgery, this is the first reported case of the postoperative formation of an abscess of the sphenoi...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199101000-00022
更新日期:1991-01-01 00:00:00
abstract:OBJECTIVE:The goal was to develop a low-cost, national, neurosurgical emergency teleconsulting system that is independent of vendor computed tomographic (CT) or magnetic resonance imaging (MRI) scanner type. METHODS:Charge-coupled device scanners are used to digitize hard copies of CT and MRI scans. An enhanced optica...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199801000-00020
更新日期:1998-01-01 00:00:00
abstract::In order to understand the effects and the direction of pressure transmitted from a mass lesion through various brain structures, miniature strain gauges were inserted in different brain locations in eight anesthetized monkeys. Mass lesions were created by inflating a balloon in either of two locations--subcortical in...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199210000-00017
更新日期:1992-10-01 00:00:00
abstract::The author reports some of his early personal neurosurgical experiences spent among some of the great figures in neurosurgery and among some of the founders and pioneers of functional neurosurgery, stereotaxy, and clinical neurophysiology during the mid-1960s. This historical vignette represents recognition of the leg...
journal_title:Neurosurgery
pub_type: 历史文章,杂志文章
doi:10.1227/01.neu.0000146208.22449.54
更新日期:2005-01-01 00:00:00
abstract:OBJECTIVE:To determine whether low-grade gliomas contain functional cortical activity more often than high-grade gliomas within radiologically defined abnormal tissue. METHODS:Patients with intra-axial cerebral lesions located in the vicinity of eloquent brain cortex preoperatively underwent magnetic source imaging. A...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-200112000-00005
更新日期:2001-12-01 00:00:00
abstract:OBJECTIVE:Currently, because of the precision of stereotactic radiosurgery, radiation can now be delivered by techniques that shape the radiation beam to the tissue target for a variety of clinical applications. This avoids unnecessary and potentially damaging irradiation of surrounding tissues inherent in conventional...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.NEU.0000330404.37092.3E
更新日期:2008-11-01 00:00:00
abstract::Eleven athymic nude rats had stereotactic intracerebral inoculation of cells from one of three established human glioma cell lines (A172, A1207, and A1235). The implants grew progressively in 9 of 11 instances, which led to spontaneous death of the host in 14 to 37 days. For comparison, two Sprague-Dawley normal albin...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract:IMPORTANCE:Rhinocerebral mucormycosis is extremely difficult to treat. Approximately 70% of patients are poorly controlled diabetics, and many of the remainder are immunocompromised as a consequence of cytotoxic drugs, burn injuries, or end-stage renal disease. Despite standard treatment consisting of surgical debridem...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199803000-00037
更新日期:1998-03-01 00:00:00
abstract:OBJECTIVE:In rare cases, space-occupying pseudoarthrotic clavicular nonunion causes symptomatic brachial plexus compression. The surgical treatment of clavicular pseudoarthrosis has been extensively reported in the literature. This article reports our experience of a definitive treatment strategy using free vascularize...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000326036.54714.17
更新日期:2008-05-01 00:00:00
abstract::Because conventional stereotactic angiography provides only two-dimensional information for dose planning, we studied the accuracy and usefulness of stereotactic magnetic resonance angiography (sMRA) for arteriovenous malformation (AVM) radiosurgery in 28 consecutive patients. We hypothesized that the multidimensional...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199410000-00002
更新日期:1994-10-01 00:00:00
abstract:OBJECTIVE:Socioeconomic changes have imposed many administrative demands on neurosurgeons, including managing facilities such as the intensive care unit without absolute authority and maintaining referrals, marketing in an increasingly competitive environment, effecting change within stubborn hospital systems, negotiat...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000318180.80040.d0
更新日期:2008-04-01 00:00:00
abstract:OBJECTIVE:The snake venom disintegrin contortrostatin (CN) is able to inhibit tumor progression and angiogenesis in vivo and therefore is of considerable interest as a potential antitumor drug. CN specifically binds to certain integrins on the tumor cell and angiogenic endothelial cell surface and inhibits their intera...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000163426.25227.56
更新日期:2005-07-01 00:00:00
abstract::Cell therapy has been widely recognized as a promising strategy to enhance recovery in stroke survivors. However, despite an abundance of encouraging preclinical data, successful clinical translation remains elusive. As the field continues to advance, it is important to reexamine prior clinical trials in the context o...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyaa531
更新日期:2020-12-28 00:00:00
abstract::A study was undertaken to determine how frequently angiographic vasospasm occurs outside the normal access range of transcranial Doppler ultrasound in patients who have suffered a subarachnoid hemorrhage. Vasospasm located in the basal vessels is readily identifiable using transcranial Doppler ultrasound whereas spasm...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:
更新日期:1990-10-01 00:00:00
abstract:BACKGROUND:While multiple new larger-bore aspiration catheters have been introduced for stroke thrombectomy, sizeable cohort outcome studies are lacking along with meaningful comparative studies to evaluate whether they represent a clinically relevant improvement compared to predecessors. OBJECTIVE:To evaluate compara...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyaa498
更新日期:2020-12-28 00:00:00
abstract::Intracisternal thrombolysis with recombinant tissue plasminogen activator (rtPA) was performed in 20 patients with aneurysmal subarachnoid hemorrhage. All patients had blood accumulations in the basal cisterns according to Fisher's Grade III, thus being at a high risk for the development of posthemorrhagic delayed isc...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-199206000-00010
更新日期:1992-06-01 00:00:00
abstract::Review of 1105 records patients with penetrating craniocerebral injuries incurred in the Korean War revealed 163 cases with air sinus wounds, an incidence of 14.8%. The characteristics of these wounds and their surgical management have been described. Foremost among the complications of air sinus wounds are the develo...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/00006123-198310000-00005
更新日期:1983-10-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:Two patients with vertebrobasilar dolichoectasia sustained massive fatal subarachnoid hemorrhage from rupture of the basilar artery wall. Hemorrhage from this entity is not widely known to occur during its natural history and may be exacerbated by systemic anticoagulation. CLINICAL PRESENTATIO...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199802000-00108
更新日期:1998-02-01 00:00:00
abstract:BACKGROUND:The Centers for Disease Control and Prevention have called for studies detailing the prevalence and burden of mild traumatic brain injury (mTBI) in the outpatient clinical setting. OBJECTIVE:The aim of this study was to describe the prevalence of outpatient visits for minor head injury and compare the numbe...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000429846.14579.41
更新日期:2013-07-01 00:00:00
abstract:OBJECTIVE:We evaluated somatosensory and motor interhemispheric integration in four patients who underwent transection of different portions of the anterior corpus callosum (CC) for removal of an intraventricular cyst. The study goal was to relate their performances to the topographical organization of the CC. METHODS...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000163089.31657.08
更新日期:2005-07-01 00:00:00
abstract:BACKGROUND:Surgery for degenerative cervical spine disease has escalated since the 1990s. Fusion has become the mainstay of surgery despite concerns regarding adjacent segment degeneration. The patient-specific trends in reoperations have not been studied previously. OBJECTIVE:To analyze the occurrence, risk factors, ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1093/neuros/nyaa464
更新日期:2020-12-28 00:00:00
abstract:OBJECTIVE:To determine the usefulness of endovascular embolization for treatment of dural arteriovenous fistulae of the superior petrosal sinus. METHODS:We performed a retrospective review of 18 patients treated during a 16-year period. Transarterial and/or transvenous embolizations were performed as a preoperative ad...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/01.neu.0000068790.37318.24
更新日期:2003-07-01 00:00:00
abstract::Experience with 120 patients who incurred a gunshot wound to the head with dural penetration is presented. All of the patients were managed by a standard resuscitation protocol and assigned a clinical grade based on their level of consciousness both at the time of presentation and at 2 to 4 months after injury. Fifty ...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1097/00006123-199107000-00011
更新日期:1991-07-01 00:00:00
abstract:BACKGROUND:For the prevention of postoperative CSF fistula a better understanding of origins and risk factors is necessary. OBJECTIVE:To identify the petrous bone air cell volume as a risk factor for developing CSF fistula, we performed a retrospective analysis. METHODS:From 2000 to 2007 519 patients had a retrosigmo...
journal_title:Neurosurgery
pub_type: 杂志文章
doi:10.1227/NEU.0b013e3181f88884
更新日期:2010-12-01 00:00:00