{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T18:31:55Z","timestamp":1786386715592,"version":"build-2736575974"},"reference-count":41,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T00:00:00Z","timestamp":1761868800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T00:00:00Z","timestamp":1761868800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      Patients with large vestibular schwannomas (VS) are at higher risk for adverse outcomes following microsurgical resection.\n                      <jats:italic>This<\/jats:italic>\n                      study aims to identify clinical and radiographic factors that may be predictive of adverse outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective chart review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Academic tertiary care center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A chart review of patients with Koos III or IV VS from 2016 to 2020 was conducted. Demographics, preoperative 11\u2010item modified frailty index (mFI\u201011), and surgical information were collected: preoperative Koos score and the total tumor volume (TV) on T2 MRI sequences. Preoperative and postoperative tumor characteristics, symptoms, and House\u2010Brackmann (HB) facial nerve function were assessed. Outcomes included increased length of stay (LOS; defined as &gt;4 days), nonhome discharge (NHD), and surgical complications. Statistical analysis was performed with SPSS version 29.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 79 patients were identified; 54% were female and 86% were white. On univariable binary logistic regression analysis, factors associated with increased LOS included surgical time, TV, frailty (measured by mFI\u201011), and any surgical complication. On multivariable analysis, only increased frailty (odds ratio [OR]: 12.99; 95% CI: 2.06\u201081.91), surgical time (OR: 1.01; 95% CI: 1.00\u20101.02), and having a surgical complication (OR: 5.95; 95% CI: 1.48\u201023.87) were independent predictors of LOS. The only independent predictor of NHD was VP shunt placement after surgery (OR: 9.71; 95% CI: 1.18\u201080.02). There were no other independent predictors of LOS, NHD, or surgical complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Frailty, as measured by increased mFI\u201011, surgical time, and surgical complications were independent predictors of increased LOS. VP shunt placement after surgery was an independent predictor of NHD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.70063","type":"journal-article","created":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T08:26:35Z","timestamp":1761899195000},"page":"495-502","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Frailty, Surgical Time, and Surgical Complications Increase Length of Stay Following Large Vestibular Schwannoma Resection"],"prefix":"10.1002","volume":"174","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-4522-8407","authenticated-orcid":false,"given":"Jason L.","family":"Steele","sequence":"first","affiliation":[{"name":"Rocky Vista University College of Osteopathic Medicine Ivins Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole J.","family":"Ewer","sequence":"additional","affiliation":[{"name":"University of Utah School of Medicine Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather J.","family":"Smith","sequence":"additional","affiliation":[{"name":"University of Utah School of Medicine Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samira","family":"Takkoush","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Utah Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa Shuhui","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Radiology and Imaging Services University of Utah Salt Lake City Utah USA"},{"name":"Department of Neuroradiology Singapore General Hospital  Singapore"},{"name":"Department of Neuroradiology National Neuroscience Institute  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard H.","family":"Wiggins","sequence":"additional","affiliation":[{"name":"Department of Radiology and Imaging Services University of Utah Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mana","family":"Espahbodi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Utah Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil S.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Utah Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9601-2628","authenticated-orcid":false,"given":"Richard K.","family":"Gurgel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Utah Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,31]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.130.2.216"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2020394"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCO.0000000000000904"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/neuros\/nyy409"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006123-199701000-00001"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2018.07.015"},{"key":"e_1_2_8_8_1","unstructured":"SlatteryWH. 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