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. 2011:2:105.
doi: 10.4103/2152-7806.83387. Epub 2011 Jul 30.

Predictors of inpatient complications and outcomes following surgical resection of hypothalamic hamartomas

Debraj Mukherjee  1 , Christine Carico, Miriam Nuño, Chirag G Patil
Affiliations

Predictors of inpatient complications and outcomes following surgical resection of hypothalamic hamartomas

Debraj Mukherjee et al. Surg Neurol Int. 2011.

Abstract

Background: Our aim was to identify the preoperative factors associated with a greater risk of poor inpatient outcomes in those undergoing resection of hypothalamic hamartomas.

Methods: We performed a multi-institutional retrospective cohort analysis via the Nationwide Inpatient Sample (1998 - 2007). Patients of any age who underwent resection of hypothalamic hamartomas were identified by ICD-9 coding. The primary outcomes included inpatient complications, length of stay (LOS), and total charges. Multivariate regression models were constructed to analyze the outcomes.

Results: Two hundred and eighty-two patients were identified with a mean age of 27.7 years, with most being male (53.2%), Caucasian (78.9%), privately insured (69.3%), and treated electively (74.7%) at academic centers (91.7%). A majority (82.2%) had Elixhauser comorbidity scores of < 1, indicating few comorbidities. No inpatient deaths were reported. Mean LOS was 7.39 days and the mean total hospital charges were $53,935. Overall, 19.5% developed an inpatient complication, primarily stroke (16.7%). Female gender, ethnic / racial minorities, higher comorbidity scores, private insurance, and non-academic hospitals were associated with greater LOS and total charges. Private insurance (Odds Ratio, OR: 1.59, P = 0.045) and academic hospitals (OR: 1.43, P = 0.008) were associated with significantly higher odds of any complication. Minority race / ethnicity was associated with a minimal increase in the odds of postoperative stroke (OR: 1.02, P < 0.001) relative to Caucasians.

Conclusions: Through an analysis of a 10-year multi-institutional database, we have described the surgical outcomes of patients undergoing resection of hypothalamic hamartomas. Results demonstrate significant inpatient morbidity, particularly postoperative stroke. Patient- and institution-level factors should be considered in determining the perioperative risk for such patients.

Keywords: Clinical outcomes; complications; hypothalamic hamartoma; nationwide inpatient sample.

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References

    1. Rockville, MD: Agency for Healthcare Research and Quality; [Last accessed on 2011 Jun]. HCUP Databases. Healthcare Cost and Utilization Project (HCUP) Available from: http:// www.hcup-us.ahrq.gov/nisoverview.jsp . - PubMed
    1. Abla AA, Rekate HL, Wilson DA, Wait SD, Uschold TD, Prenger E, et al. Orbitozygomatic resection for hypothalamic hamartoma and epilepsy: Patient selection and outcome. Childs Nerv Syst. 2011;27:265–77. - PubMed
    1. Andrew M, Parr JR, Stacey R, Rosenfeld JV, Hart Y, Pretorius P, et al. Transcallosal resection of hypothalamic hamartoma for gelastic epilepsy. Childs Nerv Syst. 2008;24:275–9. - PubMed
    1. Ayanian JZ, Weissman JS. Teaching hospitals and quality of care: A review of the literature. Milbank Q. 2002;80:569–93. - PMC - PubMed
    1. Berkovic SF, Arzimanoglou A, Kuzniecky R, Harvey AS, Palmini A, Andermann F. Hypothalamic hamartoma and seizures: A treatable epileptic encephalopathy. Epilepsia. 2003;44:969–73. - PubMed