Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Oct 2017
Factors associated with an increased risk of perioperative cardiac arrest in emergent and elective craniotomy and spine surgery.
Cardiac arrest following neurosurgery is a devastating complication associated with significant postoperative morbidity and mortality. There are no published studies that have used a large and robust multicenter database to specifically examine demographic and surgical risk factors associated with cardiac arrests following craniotomy and spine surgeries, respectively. ⋯ Identification of patient and surgery specific characteristics from ACS-NSQIP data associated with cardiac arrest following craniotomy and spine surgery may lead to initiatives to reduce morbidity and mortality in the neurosurgical patient population.
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Clin Neurol Neurosurg · Oct 2017
Establishing objective volume-outcome measures for anterior and posterior cervical spine fusion.
There is a growing literature on the relationship between provider volume and patient outcomes, specifically within joint arthroplasty and lumbar spine surgery. Such benchmarks have yet to be established for many other spinal procedures, including cervical fusion. We sought to determine whether outcomes-based volume measures for both surgeons and hospitals can be established for cervical spine fusion procedures. ⋯ This study demonstrates objective volume-outcome measures for surgeons who perform anterior and posterior cervical fusions. Our results have immediate applicability to clinical practice and may be used to benchmark procedural volume. Findings with respect to hospitals speak against the need for healthcare regionalization in this specific clinical context.