Abstract:
OBJECTIVE:For adult patients undergoing surgical decompression for Chiari malformation type I (CM-I), the patient-level factors that influence extended length of stay (LOS) are relatively unknown. The aim of this study was to investigate the impact of patient-baseline comorbidities, demographics, and postoperative complications on extended LOS after intervention after adult CM-I decompression surgery. METHODS:A retrospective cohort study using the National Inpatient Sample years 2010-2014 was performed. Adults (≥18 years) with a primary diagnosis of CM-I undergoing surgical decompression were identified. Weighted patient demographics, comorbidities, complications, LOS, disposition, and total cost were recorded. A multivariate logistic regression was used to determine the odds ratio for risk-adjusted LOS. RESULTS:A total of 29,961 patients were identified, 6802 of whom (22.7%) had extended LOS. The extended LOS cohort had a significantly greater overall complication rate (normal LOS, 10.6% vs. extended LOS, 29.1%; P < 0.001) and total cost (normal LOS, $14,959 ± $6037 vs. extended LOS, $25,324 ± $21,629; P < 0.001) compared with the normal LOS cohort. On multivariate logistic regression, black race, income quartiles, private insurance, obstructive hydrocephalus, lack of coordination, fluid and electrolyte disorders, and paralysis were all independently associated with extended LOS. Additional duraplasty (P = 0.132) was not significantly associated with extended LOS after adjusting for other variables. The odds ratio for extended LOS was 2.07 (95% confidence interval, 1.59-2.71) for patients with 1 complication and 9.47 (95% confidence interval, 5.86-15.30) for patients with >1 complication. CONCLUSIONS:Our study shows that extended LOS after adult CM-I decompression surgery may be influenced by multiple patient-level factors.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Elsamadicy AA,Koo AB,Lee M,David WB,Kundishora AJ,Freedman IG,Zogg CK,Hong CS,DeSpenza T,Sarkozy M,Kahle KT,DiLuna Mdoi
10.1016/j.wneu.2020.02.158subject
Has Abstractpub_date
2020-06-01 00:00:00pages
e515-e522eissn
1878-8750issn
1878-8769pii
S1878-8750(20)30433-2journal_volume
138pub_type
杂志文章abstract:BACKGROUND:Atlantoaxial instability, a common finding in patients with Down syndrome (DS), is attributed to laxity of ligamentous structures. Cervical spondylosis identified in these patients has a pathogenesis of ligament laxity and early degeneration compared with the normal population. No cases have been reported sh...
journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2020.07.040
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVES:To assess the outcomes in aggressively treated patients with aneurysmal intracerebral hematoma (ICH) and signs of brain herniation, and to investigate possible predictive factors. METHODS:This retrospective study included 43 patients with aneurysmal ICH who presented to the Emergency Department with brain h...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.03.011
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Although carotid artery stenting (CAS) has been widely acknowledged as an effective alternative option for patients at high risk of carotid endarterectomy, embolic stroke is a major complication of CAS. Several reports have emphasized that distal protection filter alone is associated with a high risk of embo...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.05.028
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVE:The aim of this systematic literature review is to evaluate recent attempts in creating a standardized multidisciplinary approach combining tumor treatment with current vertebral stabilization techniques for palliative treatment of vertebral metastasis in patients who do not fall into the NOMS (neurologic, on...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.05.042
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:High-dose bevacizumab delivered via super selective intra-arterial cerebral infusion (SIACI) is one promising clinical trial combination for patients with glioblastoma (GBM). Although both continuous intravenous and intra-arterial administration of bevacizumab, and rechallenge with intravenous bevacizumab, h...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.07.137
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:Subcallosal artery (ScA) infarction is a well-recognized but uncommon complication of surgical treatment of anterior communicating artery aneurysms. CASE DESCRIPTION:An elderly man presented with massive subarachnoid hemorrhage due to left posterior communicating artery aneurysm with thick clots in the ante...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.07.052
更新日期:2017-11-01 00:00:00
abstract:PURPOSE:Cervical stenosis with myelopathy caused by ossification of the ligamentum flavum is relatively rare, and surgical treatment is the preferred option. Previous surgical procedures usually require assisted internal fixation, while some problems may occur, such as large trauma, intraoperative bleeding, wound infec...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.12.180
更新日期:2019-01-12 00:00:00
abstract:BACKGROUND:Colloid cysts (CCs) are rare cystic lesions derived from the endoderm of the central nervous system. Although they appear most commonly in the anterior roof of the third ventricle, there are only a few reports of CCs located in the suprasellar region. Although CCs are considered to be slow-growing benign tum...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.11.258
更新日期:2019-01-18 00:00:00
abstract:BACKGROUND:Giant invasive spinal schwannomas (GISSs) comprise a rare, specific subtype of schwannomas that extend >2 spinal levels, erode vertebral bodies, and invade extraspinal tissues. Optimal surgical management of resulting spinal instability has yet to be determined, and overall there is limited published literat...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2018.02.146
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVE:To describe the technical details of 3-piece orbitozygomatic (OZ) craniotomy using a diamond threadwire saw as an alternative to cutting the orbital rim and zygoma. METHODS:The details of this procedure are presented by cadaver dissection and a surgical case. RESULTS:Three-piece OZ craniotomy consists of 3 ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.04.235
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Osteoid osteomas (OOs) are benign bone forming tumors that, usually, occur in the extremities, with about 10% of them arising in the spine more commonly in the posterior elements. The aim of this study is to evaluate the long-term results of patients suffering from spinal OO treated with surgery and radiofre...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.10.050
更新日期:2021-01-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to develop a perioperative metastatic spinal tumor frailty index (MSTFI) that could predict morbidity, mortality, and length of stay. METHODS:A large inpatient hospitalization database was searched from 2002 to 2011 to identify 4583 patients with spinal metastasis from breast (21.1%...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.08.029
更新日期:2016-11-01 00:00:00
abstract:OBJECTIVE:To describe the neuroendoscopic technique to deal with intraventricular tumors. METHODS:Details of the endoscopic approach to intraventricular tumors of the lateral, third, and fourth ventricle are presented. RESULTS:Intraventricular tumors are ideal indications for neuroendoscopic surgery. They often cause...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2012.02.023
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:Adenocarcinomas of müllerian origin are malignancies derived from tissues of the proximal third of the vagina, cervix, uterus, and fallopian tubes. These organs develop from the embryologic müllerian ducts. While reports of perineural spread of certain uterine and cervical carcinomas exist in the literature,...
journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2020.06.121
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Posterior fossa arachnoid cysts are often asymptomatic, but can rarely cause postural headache, the mechanism of which remains unknown. CASE DESCRIPTION:We present a 40-year-old woman with an asymptomatic supracerebellar arachnoid cyst. Upright computed tomography (CT) showed enlargement of the arachnoid cy...
journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2020.09.132
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:Rising cost and limited resources remain major challenges to U.S. health care and neurosurgery in particular. To ensure an efficient and cost-effective health care system, it is important that referrals to neurosurgery clinics are appropriate, and that referred patients have a reasonably high probability of ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.02.095
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:The balloon occlusion test (BOT) is a well-accepted technique for the treatment of large or complex aneurysms. However, this procedure may not be feasible for small arteries such as the posterior inferior cerebellar artery (PICA). We report our experience with endovascular treatment of a fusiform PICA aneury...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2010.05.002
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:The cause of postoperative heterotopic ossification (HO) after cervical disc replacement (CDR) is unclear. The aim of the present study was to investigate the incidence of HO, its clinical significance, and whether the degree of preoperative degeneration was associated with its occurrence. METHODS:Patients ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.01.244
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Affective symptoms are frequent in patients with brain tumors. The origin of such symptoms is unknown; either focal brain injury or reactive emotional distress may be responsible. This cross-sectional pilot study linked depressive symptoms and anxiety to white matter integrity. The objective was to test the ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2015.05.031
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVE:Neuroendoscopy is increasingly being used in the management of intraventricular brain tumors. The role of endoscopy in diagnostic biopsy is well established. Expansion of these techniques may allow for definitive resection of intraventricular tumors. We report the feasibility and outcomes of endoscopic resect...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2015.11.052
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVE:To explore the effect and safety of transforaminal percutaneous endoscopic decompression for lower thoracic spinal stenosis. METHODS:We reviewed 6 patients receiving transforaminal percutaneous endoscopic thoracic decompression for sympathetic symptoms in the lower extremities. Pre- and postoperative Frankel...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.04.186
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVE:To compare outcomes in the setting of spontaneous intracerebral hemorrhage (ICH) in patients taking aspirin (acetylsalicylic acid [ASA]) versus patients taking clopidogrel before hospitalization. METHODS:Patients admitted to the neurosurgical service with a spontaneous ICH while taking an antiplatelet agent ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2011.02.010
更新日期:2011-07-01 00:00:00
abstract:OBJECTIVE:The petrosquamosal sinus (PSS) is clinically important as it represents a potential hemorrhagic hazard during neurosurgical procedures. This double-approach radiologic study and meta-analysis aimed to assess the imaging characteristics of the PSS on computed tomography (CT) and systematically analyze its prev...
journal_title:World neurosurgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.wneu.2017.12.132
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVE:The American Association and Congress of Neurological Surgeons recommended mean arterial blood pressure (MAP) in patients with acute spinal cord injury (SCI) should be 85-90 mm Hg for the first 7 days. We evaluated whether hemodynamic management differed between a primary-receiving and tertiary hospital in th...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.04.106
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:The major difficulty in treating glioblastoma stems from the intrinsic privileged nature of the brain. This complicates therapy, as many traditionally potent chemotherapeutics cannot access their target sites in the brain. Several techniques have been investigated to overcome this barrier and facilitate drug...
journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2020.07.132
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Lateral lumbar interbody fusion (LLIF) has steadily increased in popularity. Compared with the traditional transforaminal lumbar interbody fusion (TLIF), LLIF is thought to allow for greater improvement in lordosis. However, there are limited direct comparison data on the degree of regional and global alignm...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.03.106
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:Sufficient visualization of the operating field is crucial for success in surgery and is important especially concerning minimally invasive and deep approaches in spine surgery. METHODS:The spinal microsurgical approach was imitated using an isolated box that was accessed with different devices. Different l...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.06.013
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:Results from studies investigating the effect of contralateral carotid occlusion (CCO) in patients with carotid artery stenosis undergoing carotid artery endarterectomy (CEA) or carotid artery stenting (CAS) are variable in the literature. We sought to determine whether CEA or CAS is the optimal revasculariz...
journal_title:World neurosurgery
pub_type: 杂志文章,meta分析
doi:10.1016/j.wneu.2018.08.183
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Embolization of the middle meningeal artery (MMA) has recently been proposed as an alternative to surgery for treatment of chronic subdural hematoma (SDH). There is increasing evidence that fragile neovasculature arising from distal branches of the MMA found within the membrane that forms around a chronic SD...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.06.241
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVE:Thalamic glioma is a type of midline glioma with poor outcomes. In the present study, we investigated the clinical and molecular features of thalamic gliomas in Chinese patients. METHODS:The data from 26 patients with thalamic glioma who had undergone surgery at Shanghai Huashan Hospital from January 2011 to...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.03.061
更新日期:2019-06-01 00:00:00