Evidence map›Paper›PMID 39266885›Full record

ArticleJournal of neuro-oncology2024

Procedural volume is linearly associated with mortality, major complications, and readmissions in patients undergoing malignant brain tumor resection.

Jane S Han, Talia Wenger, Alexandra N Demetriou, Jonathan Dallas, Li Ding, Gabriel Zada, William J Mack, Frank J Attenello

Abstract read
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In one paragraph

Article in Journal of neuro-oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

8 authors.

Jane S HanDepartment of Neurological Surgery, Keck School of Medicine, University of Southern California, 1200 North State St. Suite 3300, Los Angeles, CA, 90033, USA. hansungm@usc.edu.
Talia WengerDepartment of Neurological Surgery, Keck School of Medicine, University of Southern California, 1200 North State St. Suite 3300, Los Angeles, CA, 90033, USA.
Alexandra N DemetriouDepartment of Neurological Surgery, Keck School of Medicine, University of Southern California, 1200 North State St. Suite 3300, Los Angeles, CA, 90033, USA.
Jonathan DallasDepartment of Neurological Surgery, Keck School of Medicine, University of Southern California, 1200 North State St. Suite 3300, Los Angeles, CA, 90033, USA.
Li DingDepartment of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Gabriel ZadaDepartment of Neurological Surgery, Keck School of Medicine, University of Southern California, 1200 North State St. Suite 3300, Los Angeles, CA, 90033, USA.
William J MackDepartment of Neurological Surgery, Keck School of Medicine, University of Southern California, 1200 North State St. Suite 3300, Los Angeles, CA, 90033, USA.
Frank J AttenelloDepartment of Neurological Surgery, Keck School of Medicine, University of Southern California, 1200 North State St. Suite 3300, Los Angeles, CA, 90033, USA.

Funding

Southern California Clinical and Translational Science InstituteUL1TR001855 · NCATS · UNIVERSITY OF SOUTHERN CALIFORNIA · PI Thomas A Buchanan, Michele D. Kipke · 2016 to 2026
$81.3M
National Center for Advancing Translational Science (NCATS) of the U.S. National Institutes of Health UL1TR001855NCATS NIH HHS UL1 TR001855
6 · The paper itself

Abstract

purposeImproved outcomes have been noted in patients undergoing malignant brain tumor resection at high-volume centers. Studies have arbitrarily chosen high-volume dichotomous cutoffs and have not evaluated volume-outcome associations at specific institutional procedural volumes. We sought to establish the continuous association of volume with patient outcomes and identify cutoffs significantly associated with mortality, major complications, and readmissions. We hypothesized that a linear volume-outcome relationship can estimate likelihood of adverse outcomes when comparing any two volumes.

methodsThe patient cohort was identified with ICD-10 coding in the Nationwide Readmissions Database(NRD). The association of volume and mortality, major complications, and 30-/90-day readmissions were evaluated in multivariate analyses. Volume was used as a continuous variable with two/three-piece splines, with various knot positions to reflect the best model performance, based on the Quasi Information Criterion(QIC).

resultsFrom 2016 to 2018, 34,486 patients with malignant brain tumors underwent resection. When volume was analyzed as a continuous variable, mortality risk decreased at a steady rate of OR 0.988 per each additional procedure increase for hospitals with 1-65 cases/year(95% CI 0.982-0.993, p < 0.0001). Risk of major complications decreased from 1 to 41 cases/year(OR 0.983, 95% CI 0.979-0.988, p < 0.0001), 30-day readmissions from 1 to 24 cases/year(OR 0.987, 95% CI 0.979-0.995, p = 0.001) and 90-day readmissions from 1 to 23 cases/year(OR 0.989, 95% CI 0.983-0.995, p = 0.0003) and 24-349 cases/year(OR 0.9994, 95% CI 0.999-1, p = 0.01).

conclusionIn multivariate analyses, institutional procedural volume remains linearly associated with mortality, major complications, and 30-/90-day readmission up to specific cutoffs. The resulting linear association can be used to calculate relative likelihood of adverse outcomes between any two volumes.

Indexed as

Brain NeoplasmsNeurosurgical ProceduresPatient ReadmissionPostoperative ComplicationsAdultAgedFemaleHospitals, High-VolumeHumansMaleMiddle AgedHospital volumeMalignant brain tumorNationwide readmissions databaseResection

Identifiers

PMID39266885
PMCPMC11538139

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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.