• Sima Vazquez, Jose F Dominguez, Eva Wu, Eris Spirollari, Sauson Soldozy, Michael E Ivan, Martin Merenzon, Simon J Hanft, and Ricardo J Komotar.
• School of Medicine, New York Medical College, Valhalla, New York, USA. Electronic address: Sazquez6@student.nymc.edu.
• World Neurosurg. 2024 Mar 1; 183: e787e795e787-e795.

BackgroundImproved outcomes in surgical patients have been associated with increasing volume of cases. This has led to the development of centers that facilitate care for a specific patient population. This study aimed to evaluate associations of outcomes with hospital characteristics in patients undergoing resection of malignant brain tumors.MethodsThe 2016-2020 National Inpatient Sample was queried for patients undergoing resection of malignant brain tumors. Teaching hospitals with caseloads >2 standard deviations above the mean (140 cases) were categorized as high-volume centers (HVCs). Value of care was evaluated by adding one point for each of the following: short length of stay, low total charges, favorable discharge disposition, and lack of major comorbidity or complication.ResultsIn 3009 hospitals, 118,390 patients underwent resection of malignant brain tumors. HVC criteria were met by 91 (3%) hospitals. HVCs were more likely to treat patients of younger age or higher socioeconomic status (P < 0.01 for all). The Mid-Atlantic and South Atlantic regions had the highest percentage of cases and number of HVCs. Value of care was higher at HVCs (P < 0.01). Care at HVCs was associated with decreased complications (P < 0.01 for all) and improved patient outcomes (P < 0.01 for all).ConclusionsPatients undergoing craniotomy for malignant brain neoplasms have superior outcomes in HVCs. Trends of centralization may reflect the benefits of multidisciplinary treatment, geographic preferences, publicity, and cultural impact. Improvement of access to care is an important consideration as this trend continues.Copyright © 2024 Elsevier Inc. All rights reserved.

14 keywords...

hide…