Abstract：
BACKGROUND:The mortality index, or the ratio of observed to expected mortality, is a reported quality metric that has been assumed to directly reflect patient care. However, documentation and coding that does not use knowledge of how a reported mortality index is derived could reflect poorly on a hospital or service line. We present our effort at reducing the reported mortality index of neurosurgery and neurology patients within a neurocritical care unit through documentation and coding accuracy with direct incorporation of mortality modeling. METHODS:Using a reported method from Vizient Inc., we generated a spreadsheet tool to enable direct manipulation of the data to identify documentation and coding issues that influenced the reported mortality index in a retrospective set of patients. Subsequently, we implemented the prospective changes to documentation and coding and compared our calculated mortality index to the reported Vizient mortality index. RESULTS:Prospective implementation of the documentation and coding issues identified through our spreadsheet tool resulted in a drastic reduction of both our calculated and the reported Vizient mortality index. CONCLUSIONS:Incorporating knowledge of mortality index modeling into the documentation and coding resulted in impressive reductions in the reported mortality index for our patients, serving as a both an internal benchmark and a method of comparison with other institutions.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Kessler BA,Catalino MP,Jordan JDdoi
10.1016/j.wneu.2019.10.022subject
Has Abstractpub_date
2020-01-01 00:00:00pages
e819-e827eissn
1878-8750issn
1878-8769pii
S1878-8750(19)32637-3journal_volume
133pub_type
杂志文章abstract：BACKGROUND:Metastatic meningiomas (MMs) are rare (0.1 of 100 cases). Their treatment requires a multimodal approach, with surgery, radiotherapy, chemotherapy, and radiosurgery, which allows a long-term local control (LC) and an extension of free survival. In this study, the authors performed a review of the literature ...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2019.05.058
更新日期：2019-08-01 00:00:00
abstract：OBJECTIVE:Multiple factors are known to influence outcomes in single-aneurysm subarachnoid hemorrhage, such as Hunt and Hess (H&H) grade, hypertension, etc. We sought to assess the influence of individual risk factors on outcome in surgically managed patients with multiple intracranial aneurysm. METHODS:A retrospectiv...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2016.02.058
更新日期：2016-06-01 00:00:00
abstract：BACKGROUND:Spinal tuberculosis is the most common form of tuberculosis affecting bone and often needs surgical treatment. Single anterior, single posterior, and combined anterior and posterior approaches are the 3 most commonly used approaches in surgical treatment. Clinically, the choice of optimal surgical approach r...
journal_title：World neurosurgery
pub_type： 杂志文章,评审
doi：10.1016/j.wneu.2020.12.023
更新日期：2020-12-11 00:00:00
abstract：OBJECTIVE:Anterior skull base neoplastic and vascular lesions can receive significant blood supply from the anterior and posterior ethmoidal artery. Although useful in preoperative embolization of middle meningeal artery branches, endovascular techniques for the occlusion of anterior ethmoidal artery expose the parent ...
journal_title：World neurosurgery
pub_type： 杂志文章,meta分析,评审
doi：10.1016/j.wneu.2015.06.005
更新日期：2015-10-01 00:00:00
abstract：BACKGROUND:Because peripheral nerve surgery has become more common in recent years, the pressure to increase this procedure's health care safety and cost-effectiveness has increased. Given our limited understanding, we evaluated prospectively identified and randomly sampled patients who underwent peripheral nerve surge...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2016.07.023
更新日期：2016-10-01 00:00:00
abstract：OBJECTIVE:Muscle injury is inevitable during surgical exposure of the spine. This study compared paraspinal muscle injury after 4 surgical techniques: microdiscectomy (MD), percutaneous endoscopic lumbar discectomy (PELD), percutaneous endoscopic interlaminar discectomy (PEID), unilateral biportal endoscopic discectomy...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2018.05.085
更新日期：2018-08-01 00:00:00
abstract：:We studied a poorly known form of cerebrospinal fluid hypotension characterized by cervical myelopathy, a considerable growth in volume of the venous plexus of the cervical spine, and absence of headache. This form was first described by Miyazaki. We reported a case brought to our attention, reviewed the literature, a...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2015.04.030
更新日期：2015-09-01 00:00:00
abstract：:This case Video 1 demonstrates a microsurgical technique for trapping and excision of 2 ruptured mycotic aneurysms. The patient was a 64-year-old man with severe mitral regurgitation and valvular vegetations suggestive of endocarditis. On examination, the patient presented with speech difficulty. Preoperative imaging ...
journal_title：World neurosurgery
pub_type：
doi：10.1016/j.wneu.2020.01.145
更新日期：2020-05-01 00:00:00
abstract：BACKGROUND:Spinal cord injury (SCI) without computed tomography evidence of trauma is underreported in adults and is considered a subtype of SCI with relatively good outcome. Despite this, few studies have been performed to determine specific imaging-related prognostic factors. Our objective is to describe the imaging ...
journal_title：World neurosurgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.wneu.2016.12.005
更新日期：2017-03-01 00:00:00
abstract：OBJECTIVE:In this study, we retrospectively reviewed our experience in the surgical management of solitary fibrous tumor (SFT)/hemangiopericytomas (HPCs) of the spinal cord. METHODS:Sixteen patients with SFT/HPCs of the spinal cord were enrolled in this study. Data on clinical presentation, radiologic findings, histop...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2018.12.004
更新日期：2019-03-01 00:00:00
abstract：BACKGROUND:Glioblastoma multiforme (GBM) is a rapid-growing central nervous system neoplasm. We report a case of GBM with extensive intramedullary lumbar drop metastasis and highly unusual osseous spine metastasis from a primary infratentorial GBM occurring 10 years after the initial diagnosis, which to our knowledge h...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2019.07.142
更新日期：2019-11-01 00:00:00
abstract：BACKGROUND:Staphylococcus lugdunensis is a coagulase-negative staphylococcus with aggressive and rapidly progressive infectious behavior. This organism has emerged as an important pathogen implicated in both community-acquired and nosocomial infections, including meningitis, brain abscess, catheter-related bacteremia, ...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2013.01.046
更新日期：2013-12-01 00:00:00
abstract：BACKGROUND:None of the existing prognostic scoring systems for spinal epidural abscess (SEA) include albumin despite albumin's established role in inflammation, nutrition, lipid peroxidation, and regulation of apoptosis. The purpose of the present study was to determine the prognostic value of albumin in SEA. METHODS:...
journal_title：World neurosurgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.wneu.2018.11.182
更新日期：2019-03-01 00:00:00
abstract：BACKGROUND:Cavernous hemangiomas account for 5%-13% of central nervous system vascular lesions. They are usually found intra-axially but rarely involve extra-axial structures, most commonly the middle cranial fossa. A cavernous hemangioma manifesting as a clinoid meningioma is extremely rare. CASE DESCRIPTION:A 36-yea...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2017.02.029
更新日期：2017-04-01 00:00:00
abstract：BACKGROUND:Surgical treatment of patients with atlantoaxial instability caused by pathologic changes of the skull base and craniovertebral junction combined with anterior compression of the brain stem is still associated with substantial technical difficulties and remains a matter of debate. Currently, anterior stabili...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2017.09.124
更新日期：2018-01-01 00:00:00
abstract：BACKGROUND:Various radiologic patterns of posterior reversible encephalopathy syndrome (PRES) have been reported. Among them, PRES involving brainstem, thalamus, or deep white matter and lacking parieto-occipital edema is rare. Although PRES in general has a benign course, PRES-related intracranial hemorrhage has been ...
journal_title：World neurosurgery
pub_type： 杂志文章,评审
doi：10.1016/j.wneu.2019.10.196
更新日期：2020-02-01 00:00:00
abstract：BACKGROUND:A critical step in the far lateral approach (FLA) is exposure of the V3 segment of the vertebral artery, located deep in the suboccipital triangle (SOT). Safe exposure of the SOT is achieved by means of a plane-by-plane dissection, which carries the risk of devascularization. A suitable alternative is to lif...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2018.02.090
更新日期：2018-05-01 00:00:00
abstract：BACKGROUND:Chiari 1 malformation is a structural abnormality of the hindbrain and posterior fossa characterized by herniation of the cerebellar tonsils through the foramen magnum. Although asymptomatic in some cases, hindbrain herniation can be associated with disruption of cerebrospinal fluid flow dynamics at the cran...
journal_title：World neurosurgery
pub_type：
doi：10.1016/j.wneu.2020.03.218
更新日期：2020-07-01 00:00:00
abstract：OBJECTIVE:Recent studies have suggested that retethering in patients operated for a tight or fatty filum is higher than previously predicted. In this retrospective review, outcome, complications, and risk of reoperation for recurrent tethered cord syndrome (TCS) at our own institution were investigated. METHODS:The me...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2011.05.017
更新日期：2012-01-01 00:00:00
abstract：BACKGROUND:Traumatic brain injury (TBI) is the most common neurosurgical condition globally. In Cameroon, there are 572 cases of TBI per 100,000 people, but <40% of Cameroonians live within 4 hours of a neurosurgical facility. We sought to understand the clinical outcomes at a neurosurgical center in Central Cameroon. ...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2020.06.182
更新日期：2020-10-01 00:00:00
abstract：OBJECTIVE:Susceptibility artifacts from metal clips in magnetic resonance (MR) imaging present an obstacle to evaluating the status of clipped aneurysms, parent arteries, and adjacent brain parenchyma. We aimed to develop MR-compatible aneurysm clips. METHODS:Considering the mechanical and biologic properties, as well...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2018.03.130
更新日期：2018-07-01 00:00:00
abstract：BACKGROUND:Intracranial hypotension (IH) is a recognized cause of coma; however, the diagnosis is often challenging, especially in patients with superimposed traumatic brain injury. CASE DESCRIPTION:A 67-year-old woman became comatose following evacuation of bilateral acute subdural hematomas with concurrent respirato...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2017.06.060
更新日期：2017-09-01 00:00:00
abstract：OBJECTIVE:This study aims to assess whether the A1 segment hypoplasia is a risk factor for unfavorable radiologic and clinical outcomes of surgical clipping anterior communicating artery (ACoA) aneurysm. METHODS:We retrospectively reviewed 251 patients with ACoA aneurysm who underwent surgical clipping in Beijing Tian...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2017.07.122
更新日期：2017-10-01 00:00:00
abstract：BACKGROUND:Subarachnoid hemorrhage (SAH) is managed across the full spectrum of healthcare, from clinical diagnosis to management of the hemorrhage and associated complications. Knowledge of the pathogenesis and pathophysiology of SAH is widely known; however, a full understanding of the underlying molecular, cellular,...
journal_title：World neurosurgery
pub_type： 杂志文章,评审
doi：10.1016/j.wneu.2017.10.016
更新日期：2018-01-01 00:00:00
abstract：OBJECTIVE:To report on our experience with the Elekta Extend system, a relocatable frame system used in patients with brain metastases for single-session, hypofractionated, or staged hypofractionated Gamma Knife radiosurgery (GKRS); and the evaluation of its efficacy. METHODS:From March 2014 to September 2016, 856 pat...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2018.07.157
更新日期：2018-11-01 00:00:00
abstract：BACKGROUND:Cyclooxygenase 2 (COX-2) is a key enzyme in the synthesis of prostaglandins. Recent studies have shown that overexpression of COX-2 can reduce the antitumor effect of the immune system by inhibiting the proliferation of B and T lymphocytes. Programmed cell death ligand 1 (PD-L1) was the first functionally ch...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2020.09.031
更新日期：2020-12-01 00:00:00
abstract：OBJECTIVE:The aim of the study was to examine the clinical effect of postoperative hyperbaric oxygen (HBO) therapy on symptoms and signs in the ventriculoperitoneal (VP) shunt insertion treatment of idiopathic normal pressure hydrocephalus (iNPH). METHODS:We conducted a retrospective analysis of 61 patients treated at...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2017.05.003
更新日期：2017-08-01 00:00:00
abstract：INTRODUCTION:While surgical resection remains a primary treatment for accessible arteriovenous malformations (AVMs), stereotactic radiosurgery (SRS) has become thoroughly integrated into the AVM armamentarium; however, delayed sequelae of this treatment have become evident with increased long-term follow-up. To our kno...
journal_title：World neurosurgery
pub_type： 杂志文章,评审
doi：10.1016/j.wneu.2017.12.109
更新日期：2018-03-01 00:00:00
abstract：OBJECTIVE:To investigate the incidence, distribution characteristics, and radiographic features of the ossification of the posterior longitudinal ligament (OPLL) combined with ossification of the nuchal ligament (ONL) and to analyze the correlation between the location of ONL and degree of ossification in patients with...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2018.05.130
更新日期：2018-08-01 00:00:00
abstract：BACKGROUND:Arteries that anastomose with the posterior inferior cerebellar artery (PICA) can harbor aneurysms. CASE DESCRIPTION:We present a case of a patient who suffered a subarachnoid hemorrhage as a result from an aneurysm on the left lateral spinal artery (LSA) that anastomosed to the PICA. The aneurysm was treat...
journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2018.06.085
更新日期：2018-09-01 00:00:00
