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Ryota Kurogi, Akiko Kada, Kuniaki Ogasawara, Takanari Kitazono, Nobuyuki Sakai, Yoichiro Hashimoto, Yoshiaki Shiokawa, Shigeru Miyachi, Yuji Matsumaru, Toru Iwama, Teiji Tominaga, Daisuke Onozuka, Ataru Nishimura, Koichi Arimura, Ai Kurogi, Nice Ren, Akihito Hagihara, Yuriko Nakaoku, Hajime Arai, Susumu Miyamoto, Kunihiro Nishimura and Koji Iihara

volume or CSC capabilities affect the outcomes of clipping or coiling in SAH patients. In this study, we sought to examine the effects of case volume and CSC capability on patient outcomes of clipping compared with those of coiling for SAH. Methods Hospital and Patient Selection Hospital participation in the J-ASPECT Study was voluntary. Of the 1369 training institutions certified by the Japan Neurosurgical Society, the Japanese Society of Neurology, and the Japan Stroke Society, 621 agreed to participate in this study. The J-ASPECT Study group analyzed the Diagnosis

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Roberto C. Heros

This is another excellent article relating outcome to hospital case volume; in this instance the number of operations performed for clipping of cerebral aneurysms is compared with outcome. Again, the authors have found a significant relationship between volume and outcome, as measured by mortality rates. I have just written an editorial on a similar article (Cross DT, Tirschwell DL, Clark MA, et al: Mortality rates after subarachnoid hemorrhage: variations according to hospital case volume in 18 states, J Neurosurg 99: 805–806, November, 2003) and many of the

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Roberto C. Heros

This is an excellent retrospective study of the relationship between hospital case volume and mortality rates in patients admitted through the emergency department of an acute-care hospital with the diagnosis of subarachnoid hemorrhage (SAH). The data are derived from records kept in 18 states representing 58% of the US population. Although my expertise with statistics in general and with this type of epidemiological research in particular is limited, the paper has been duly reviewed by an individual with such expertise who found no major flaws with the

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DeWitte T. Cross III, David L. Tirschwell, Mary Ann Clark, Dan Tuden, Colin P. Derdeyn, Christopher J. Moran and Ralph G. Dacey Jr.

C ase volume is related to outcome in a variety of procedures. For carotid endarterectomy, craniotomy for aneurysm clip placement, coronary artery bypass grafting, coronary angioplasty, pancreatic resection, joint replacement surgery, esophagectomy, pneumonectomy, and other surgical procedures, higher case volumes are correlated with lower mortality rates. 1, 3–6, 8, 11, 16–19, 24–26, 30 When a case volume—mortality rate relationship is identified, it may be possible to use that relationship to improve outcomes. Policies implemented in Canada and New York to

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Lorenzo Rinaldo, Brandon A. McCutcheon, Meghan E. Murphy, Daniel L. Shepherd, Patrick R. Maloney, Panagiotis Kerezoudis, Mohamad Bydon and Giuseppe Lanzino

T he surgical clipping of an unruptured intracranial aneurysm (UIA) is a technically challenging and potentially morbidity-producing procedure. 21 Greater institutional experience in the surgical treatment of UIAs has been correlated to improved functional outcome after intervention, 4 , 8 , 15 arguing for the centralization of care at specialized centers. The effect of institutional case volume on the incidence of reportable complications during and after the clipping of UIAs, however, has not been as well defined, and thus the mechanism by which greater

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Piyush Kalakoti, Osama Ahmed, Papireddy Bollam, Symeon Missios, Jessica Wilden and Anil Nanda

those arising from an implanted nervous system device. The distribution of these unfavorable outcomes across various hospital case-volume centers is noted in Table 2 . TABLE 2. Postoperative outcomes in patients undergoing DBS in the us between 2002 and 2011 (n = 33, 642) Complication Overall LVCs (n = 1728) MVCs(n = 15, 412) HVCs (n = 16, 502) p Value * Mortality 0.2% 0.0% 0.1% 0.3% 0.003 Unfavorable discharge 5.9% 7.5% 6.8% 5.0% <0.0001 High-end hospital charges 14.6% 12.4% 13.2% 16

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Natalie Limoges, Erin D’Agostino, Aaron Gelinne, Cormac O. Maher, R. Michael Scott, Gerald Grant, Mark D. Krieger, David D. Limbrick Jr., Michael White and Susan Durham

, and case volume. Table 1 outlines the topics covered by the survey. TABLE 1. Survey questions regarding pediatric neurosurgery training Question Answer Choices 1. Program name Free text 2. Geographic location Free text 3. Hospital type Freestanding/children’s hospital within an adult hospital/other 4. NACHRI-designated children’s hospital? Yes/no 5. Number of pediatric neurosurgery faculty Number 6. Number of pediatric neurosurgery faculty who are ABPNS eligible or certified Number 7. Approximate number of pediatric neurosurgery cases/year (peds ≤21 years of age

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Fatih Yakar, Sahin Hanalioglu, Balkan Sahin, Emrah Egemen, Umit A. Dere, İlker Kiraz, M. Erdal Coskun and Gokmen Kahilogullari

) training institution annual case volume (low [< 1000 or inadequate cranial/spinal case numbers] vs high [> 1000 and adequate cranial/spinal case numbers]; these numerical values were determined according to the study of Stienen et al. 13 ); and 3) training program accreditation (accredited vs nonaccredited). Statistical Analysis Statistical analyses were performed using IBM SPSS (version 22.0, IBM Corp.). Chi-square and Fisher’s exact tests were used for comparisons between groups for categorical nominal variables, whereas the Mann-Whitney U-test and Kruskal-Wallis test

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Michael C. Dewan, Abbas Rattani, Ronnie E. Baticulon, Serena Faruque, Walter D. Johnson, Robert J. Dempsey, Michael M. Haglund, Blake C. Alkire, Kee B. Park, Benjamin C. Warf and Mark G. Shrime

estimation of neurosurgical case volume by quantifying the rate at which surgical intervention and surgical consultation are indicated for neurological diseases. Methods Survey Administration We conducted a survey of neurosurgical providers using the Research Electronic Database Capture (REDCap) platform. 6 Survey structure and question format were in accordance with the methodology previously outlined by Shrime et al. 15 Surgeons had been identified via a global mapping project facilitated by the World Federation of Neurosurgical Societies (WFNS) and the Global

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Vijay M. Ravindra, Michael Karsy, Arianna Lanpher, Robert J. Bollo, Julius Griauzde, R. Michael Scott, William T. Couldwell and Edward R. Smith

can be supportive or can include operative intervention, including craniotomy for hematoma evacuation, decompressive craniectomy, or lesion excision. Resection can be done on an emergency basis or in a delayed, elective fashion. There have been no US population–based studies regarding healthcare utilization among children with CVMs. Furthermore, data to objectively compare treatment of CVMs across institutions are lacking, although hospital and provider case volume have been demonstrated to be significant predictors of morbidity and mortality when treating other