Clinical tool for prognostication of discharge outcomes following craniotomy for meningioma.
Discharge
Meningioma
NIS
Operative
Outcomes
Prediction
Journal
Clinical neurology and neurosurgery
ISSN: 1872-6968
Titre abrégé: Clin Neurol Neurosurg
Pays: Netherlands
ID NLM: 7502039
Informations de publication
Date de publication:
08 2023
08 2023
Historique:
received:
17
03
2023
revised:
07
06
2023
accepted:
14
06
2023
medline:
7
8
2023
pubmed:
6
7
2023
entrez:
5
7
2023
Statut:
ppublish
Résumé
Patients' comorbidities might affect the immediate postoperative morbidity and discharge disposition after surgical resection of intracranial meningioma. To study the impact of comorbidities on outcomes and provide a web-based application to predict time to favorable discharge. A retrospective review of the prospectively collected national inpatient sample (NIS) database was conducted for the years 2009-2013. Time to favorable discharge was defined as hospital length of stay (LOS). A favorable discharge was defined as a discharge to home and a non-home discharge destination was defined as an unfavorable discharge. Cox proportional hazards model was built. Full model for time to discharge and separate reduced models were built. Of 10,757 patients who underwent surgery for meningioma, 6554 (60%) had a favorable discharge. The median hospital LOS was 3 days (interquartile range [IQR] 2-5). In the full model, several clinical and socioeconomic factors were associated with a higher likelihood of unfavorable discharge. In the reduced model, 13 modifiable comorbidities were negatively associated with a favorable discharge except for drug abuse and obesity, which are not associated with discharge. Both models accurately predicted time to favorable discharge (c-index:0.68-0.71). We developed a web application using robust prognostic model that accurately predicts time to favorable discharge after surgery for meningioma. Using this tool will allow physicians to calculate individual patient discharge probabilities based on their individual comorbidities and provide an opportunity to timely risk stratify and address some of the modifiable factors prior to surgery.
Sections du résumé
BACKGROUND
Patients' comorbidities might affect the immediate postoperative morbidity and discharge disposition after surgical resection of intracranial meningioma.
OBJECTIVE
To study the impact of comorbidities on outcomes and provide a web-based application to predict time to favorable discharge.
METHODS
A retrospective review of the prospectively collected national inpatient sample (NIS) database was conducted for the years 2009-2013. Time to favorable discharge was defined as hospital length of stay (LOS). A favorable discharge was defined as a discharge to home and a non-home discharge destination was defined as an unfavorable discharge. Cox proportional hazards model was built. Full model for time to discharge and separate reduced models were built.
RESULTS
Of 10,757 patients who underwent surgery for meningioma, 6554 (60%) had a favorable discharge. The median hospital LOS was 3 days (interquartile range [IQR] 2-5). In the full model, several clinical and socioeconomic factors were associated with a higher likelihood of unfavorable discharge. In the reduced model, 13 modifiable comorbidities were negatively associated with a favorable discharge except for drug abuse and obesity, which are not associated with discharge. Both models accurately predicted time to favorable discharge (c-index:0.68-0.71).
CONCLUSION
We developed a web application using robust prognostic model that accurately predicts time to favorable discharge after surgery for meningioma. Using this tool will allow physicians to calculate individual patient discharge probabilities based on their individual comorbidities and provide an opportunity to timely risk stratify and address some of the modifiable factors prior to surgery.
Identifiants
pubmed: 37406426
pii: S0303-8467(23)00254-8
doi: 10.1016/j.clineuro.2023.107838
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
107838Informations de copyright
Copyright © 2023. Published by Elsevier B.V.
Déclaration de conflit d'intérêts
Declaration of Competing Interest None.