Evidence map›Paper›PMID 32147550›Full record

ArticleWorld neurosurgery2020

Risk Factors Portending Extended Length of Stay After Suboccipital Decompression for Adult Chiari I Malformation.

Aladine A Elsamadicy, Andrew B Koo, Megan Lee, Wyatt B David, Adam J Kundishora, Isaac G Freedman, Cheryl K Zogg, Christopher S Hong, Tyrone DeSpenza, Margot Sarkozy and 2 more

Open access · greenAbstract read
In one paragraph

Article in World neurosurgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.7field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 1 institution in 1 country.

Aladine A ElsamadicyDepartment of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut.
Andrew B KooDepartment of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut.
Megan LeeDepartment of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut.
Wyatt B DavidDepartment of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut.
Adam J KundishoraDepartment of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut.
Isaac G FreedmanDepartment of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut.
Cheryl K ZoggDepartment of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut.
Christopher S HongDepartment of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut.
Tyrone DeSpenzaDepartment of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut.
Margot SarkozyDepartment of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut.
Kristopher T KahleDepartment of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut.
Michael DiLunaDepartment of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut. Electronic address: Michael.Diluna@yale.edu.
Yale University · US

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
MEDICAL SCIENTIST TRAINING PROGRAMT32GM007205 · NIGMS · YALE UNIVERSITY · PI KAZMIERCZAK, BARBARA I · 1985 to 2019
$42.9M
The ED.TRAUMA Study: Evaluating the Discordance ofTrauma Readmission And Unanticipated Mortality in the Assessment of hospital qualityF30AG066371 · NIA · YALE UNIVERSITY · PI ZOGG, CHERYL K · 2019 to 2022
$163k
NCATS NIH HHS UL1 TR001863NIA NIH HHS F30 AG066371NIGMS NIH HHS T32 GM007205
6 · The paper itself

Abstract

objectiveFor adult patients undergoing surgical decompression for Chiari malformation type I (CM-I), the patient-level factors that influence extended length of stay (LOS) are relatively unknown. The aim of this study was to investigate the impact of patient-baseline comorbidities, demographics, and postoperative complications on extended LOS after intervention after adult CM-I decompression surgery.

methodsA retrospective cohort study using the National Inpatient Sample years 2010-2014 was performed. Adults (≥18 years) with a primary diagnosis of CM-I undergoing surgical decompression were identified. Weighted patient demographics, comorbidities, complications, LOS, disposition, and total cost were recorded. A multivariate logistic regression was used to determine the odds ratio for risk-adjusted LOS.

resultsA total of 29,961 patients were identified, 6802 of whom (22.7%) had extended LOS. The extended LOS cohort had a significantly greater overall complication rate (normal LOS, 10.6% vs. extended LOS, 29.1%; P < 0.001) and total cost (normal LOS, $14,959 ± $6037 vs. extended LOS, $25,324 ± $21,629; P < 0.001) compared with the normal LOS cohort. On multivariate logistic regression, black race, income quartiles, private insurance, obstructive hydrocephalus, lack of coordination, fluid and electrolyte disorders, and paralysis were all independently associated with extended LOS. Additional duraplasty (P = 0.132) was not significantly associated with extended LOS after adjusting for other variables. The odds ratio for extended LOS was 2.07 (95% confidence interval, 1.59-2.71) for patients with 1 complication and 9.47 (95% confidence interval, 5.86-15.30) for patients with >1 complication.

conclusionsOur study shows that extended LOS after adult CM-I decompression surgery may be influenced by multiple patient-level factors.

Indexed as

AdultAge FactorsArnold-Chiari MalformationDecompression, SurgicalDura MaterFemaleHumansLength of StayMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesRisk FactorsChiari I malformationExtended length of staySuboccipital decompression

Identifiers

PMID32147550
PMCPMC7379177
OpenAlexW3011426392

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.