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Open Access 01-02-2022 | Nosocomial Infection | Original Article - Brain Tumors

Applicability of contemporary quality indicators in vestibular surgery—do they accurately measure tumor inherent postoperative complications of vestibular schwannomas?

Authors: Stephanie Schipmann, Sebastian Lohmann, Bilal Al Barim, Eric Suero Molina, Michael Schwake, Özer Altan Toksöz, Walter Stummer

Published in: Acta Neurochirurgica | Issue 2/2022

Abstract

Background

Due to rising costs in health care delivery, reimbursement decisions have progressively been based on quality measures. Such quality indicators have been developed for neurosurgical procedures, collectively. We aimed to evaluate their applicability in patients that underwent surgery for vestibular schwannoma and to identify potential new disease-specific quality indicators.

Methods

One hundred and three patients operated due to vestibular schwannoma were subject to analysis. The primary outcomes of interest were 30-day and 90-day reoperation, readmission, mortality, nosocomial infection and surgical site infection (SSI) rates, postoperative cerebral spinal fluid (CSF) leak, facial, and hearing function. The secondary aim was the identification of prognostic factors for the mentioned primary outcomes.

Results

Thirty-day (90-days) outcomes in terms of reoperation were 10.7% (14.6%), readmission 9.7% (13.6%), mortality 1% (1%), nosocomial infection 5.8%, and SSI 1% (1%). A 30- versus 90-day outcome in terms of CSF leak were 6.8% vs. 10.7%, new facial nerve palsy 16.5% vs. 6.1%. Hearing impairment from serviceable to non-serviceable hearing was 6.8% at both 30- and 90-day outcome. The degree of tumor extension has a significant impact on reoperation (p < 0.001), infection (p = 0.015), postoperative hemorrhage (p < 0.001), and postoperative hearing loss (p = 0.026).

Conclusions

Our data demonstrate the importance of entity-specific quality measurements being applied even after 30 days. We identified the occurrence of a CSF leak within 90 days postoperatively, new persistent facial nerve palsy still present 90 days postoperatively, and persisting postoperative hearing impairment to non-serviceable hearing as potential new quality measurement variables for patients undergoing surgery for vestibular schwannoma.

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Title: Applicability of contemporary quality indicators in vestibular surgery—do they accurately measure tumor inherent postoperative complications of vestibular schwannomas?
Authors: Stephanie Schipmann
Sebastian Lohmann
Bilal Al Barim
Eric Suero Molina
Michael Schwake
Özer Altan Toksöz
Walter Stummer
Publication date: 01-02-2022
Publisher: Springer Vienna
Keywords: Nosocomial Infection
Vestibular Schwannoma
Vestibular Schwannoma
Published in: Acta Neurochirurgica / Issue 2/2022
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-021-05044-2

At a glance: The ONWARDS insulin icodec trials

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Applicability of contemporary quality indicators in vestibular surgery—do they accurately measure tumor inherent postoperative complications of vestibular schwannomas?

Abstract

Background

Methods

Results

Conclusions

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Abstract

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