{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T15:58:42Z","timestamp":1777305522054,"version":"3.51.4"},"reference-count":33,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,8,24]],"date-time":"2020-08-24T00:00:00Z","timestamp":1598227200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To characterize the patient and clinical factors that determine variability in hospital costs following endoscopic transphenoidal pituitary surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All endoscopic transphenoidal pituitary surgeries performed from January 1, 2015, to October 24, 2017, with complete data were evaluated in this retrospective single\u2010institution study. The electronic medical record was reviewed for patient factors, tumor characteristics, and cost variables during each hospital stay. Multivariate linear regression was performed using Stata software.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The analysis included 190 patients and average length of stay was 4.71\u2009days. Average total in\u2010hospital cost was $28,624 (95% confidence interval $25,094\u2013$32,155) with average total direct cost of $19,444 ($17,136\u2013$21,752) and total indirect cost of $9181 ($7592\u2013$10,409). On multivariate regression, post\u2010operative cerebrospinal fluid (CSF) leak was associated with a significant increase in all cost variables, including a total cost increase of $40,981 ($15,474\u2013$66,489, <jats:italic>P<\/jats:italic> =\u2009.002). Current smoking status was associated with an increased total cost of $20,189 ($6,638\u2013$33,740, <jats:italic>P<\/jats:italic> =\u2009.004). Self\u2010reported Caucasian ethnicity was associated with a significant decrease in total cost of $6646 (\u2212$12,760 to \u2212$532, <jats:italic>P<\/jats:italic> =\u2009.033). Post\u2010operative DI was associated with increased costs across all variables that were not statistically significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Post\u2010operative CSF leak, current smoking status, and non\u2010Caucasian ethnicity were associated with significantly increased costs. Understanding of cost drivers of endoscopic transphenoidal pituitary surgery is critical for future cost control and value creation initiatives.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>3 <jats:italic>Laryngoscope<\/jats:italic>, 131:760\u2013764, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.29041","type":"journal-article","created":{"date-parts":[[2020,8,24]],"date-time":"2020-08-24T21:20:00Z","timestamp":1598304000000},"page":"760-764","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["<scp>Drivers<\/scp> of <scp>In\u2010Hospital<\/scp> Costs Following Endoscopic Transphenoidal Pituitary Surgery"],"prefix":"10.1002","volume":"131","author":[{"given":"Arjun K.","family":"Parasher","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of South Florida  Tampa Florida U.S.A."},{"name":"College of Public Health University of South Florida  Tampa Florida U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0431-2920","authenticated-orcid":false,"given":"David K.","family":"Lerner","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Icahn School of Mount Sinai  New York City New York U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9076-6557","authenticated-orcid":false,"given":"Jordan T.","family":"Glicksman","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Harvard Medical School Massachusetts Eye and Ear Infirmary  Boston Massachusetts U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen P.","family":"Miranda","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery University of Pennsylvania  Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan","family":"Dimentberg","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery University of Pennsylvania  Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Darren","family":"Ebesutani","sequence":"additional","affiliation":[{"name":"Office of Clinical Research University of Pennsylvania  Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Kohanski","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery University of Pennsylvania  Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John Y. 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