{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:31:18Z","timestamp":1774225878667,"version":"3.50.1"},"reference-count":24,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg B Skull Base"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:p>Introduction\u2003We analyzed perioperative risk factors for morbidity and mortality for the patients undergoing surgical intervention for vestibular schwannoma along with rates of cerebrospinal fluid (CSF) leaks that required surgery.<\/jats:p><jats:p>Materials and Methods\u2003Patients undergoing surgery vestibular schwannoma were identified in the American College of Surgeons National Surgical Quality Improvement Program database from 2012 to 2016 using current procedural terminology (CPT) codes for posterior fossa surgical approaches and International Classification of Diseases 9th revision (ICD 9) and ICD 10 codes for peripheral nerve sheath tumor. Preoperative laboratories, comorbidities, and operative times were analyzed along with CSF leaks and unplanned returns to the operating room.<\/jats:p><jats:p>Results\u2003Nine-hundred ninety-three patients fit the inclusion criteria. Average age was 51, 41% were male, and 58% were female. Mortality within 30 days of the operation was very low at 0.4%, complications were 7% with infection being the most common at 2.3%, and unplanned reoperations happened in 7.4% of the cases. Dependent functional status (odds ratio [OR]: 5.7, 95% confidence interval [CI]: 1.9\u201316.6, p\u2009=\u20090.001), preoperative anemia (OR: 2.4, 95% CI: 1.2\u20134.5, p\u2009=\u20090.009), and operative time over 8 hours (OR: 1.9, 95% CI: 1.1\u20133.4, p\u2009=\u20090.017) were the only significant predictors of perioperative complications. CSF leak postoperatively occurred in 37 patients (3.7%). Reoperation for CSF leak was necessary in 56.3% of the cases. Operative time over 8 hours was the only independent significant predictor of postoperative CSF leak (OR: 2.2, 95% CI: 1.1\u20134.3, p\u2009=\u20090.028).<\/jats:p><jats:p>Conclusion\u2003Dependent functional status preoperatively, preoperative anemia, and duration of surgery over 8 hours are the greatest predictors of complications in the 30-day postoperative period.<\/jats:p>","DOI":"10.1055\/s-0039-1692478","type":"journal-article","created":{"date-parts":[[2019,6,21]],"date-time":"2019-06-21T22:47:37Z","timestamp":1561157257000},"page":"546-552","source":"Crossref","is-referenced-by-count":10,"title":["Risk Factors for 30-Day Non-Neurological Morbidity and Cerebrospinal Fluid Leak in Patients Undergoing Surgery for Vestibular Schwannoma"],"prefix":"10.1055","volume":"81","author":[{"given":"Yaroslav","family":"Gelfand","sequence":"additional","affiliation":[{"name":"Leo M. Davidoff Department of Neurosurgery, Montefiore Medical Ce\/Snter\/Albert Einstein College of Medicine, Bronx, New York, Unites States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2462-6118","authenticated-orcid":false,"given":"Michael","family":"Longo","sequence":"additional","affiliation":[{"name":"Albert Einstein College of Medicine, Yeshiva University, Bronx, New York, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naomi","family":"Berezin","sequence":"additional","affiliation":[{"name":"Department of Surgery, Montefiore Medical Center, Bronx, New York, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan P.","family":"Nakhla","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Rhode Island Hospital, Providence, Rhode Island, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafael","family":"De la Garza-Ramos","sequence":"additional","affiliation":[{"name":"Leo M. Davidoff Department of Neurosurgery, Montefiore Medical Ce\/Snter\/Albert Einstein College of Medicine, Bronx, New York, Unites States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vijay","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Leo M. Davidoff Department of Neurosurgery, Montefiore Medical Ce\/Snter\/Albert Einstein College of Medicine, Bronx, New York, Unites States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2019,6,21]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1288\/00005537-198702000-00001","article-title":"Acoustic tumor management in senior citizens","volume":"97","author":"J W House","year":"1987","journal-title":"Laryngoscope"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"367","DOI":"10.3171\/2009.10.JNS091203","article-title":"Beyond audiofacial morbidity after vestibular schwannoma surgery","volume":"114","author":"M E Sughrue","year":"2011","journal-title":"J Neurosurg"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1016\/S0030-6665(20)30993-2","article-title":"Complications in acoustic neuroma surgery","volume":"25","author":"R J Wiet","year":"1992","journal-title":"Otolaryngol Clin North Am"},{"issue":"02","key":"ref4","doi-asserted-by":"crossref","first-page":"312","DOI":"10.3171\/2014.10.JNS14432","article-title":"Are there modifiable risk factors to prevent a cerebrospinal fluid leak following vestibular schwannoma surgery?","volume":"122","author":"W R Copeland","year":"2015","journal-title":"J Neurosurg"},{"issue":"02","key":"ref5","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1097\/MAO.0000000000001267","article-title":"Can the risks of cerebrospinal fluid leak after vestibular schwannoma surgery be predicted?","volume":"38","author":"A Russel","year":"2017","journal-title":"Otol Neurotol"},{"issue":"08","key":"ref6","doi-asserted-by":"crossref","first-page":"3041","DOI":"10.1007\/s00405-017-4627-3","article-title":"The transotic approach for vestibular schwannoma: indications and results","volume":"274","author":"Y Xia","year":"2017","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"ref7","volume-title":"The Oral Cavity and Associated Structures","author":"W B Walker","year":"1990"},{"issue":"02","key":"ref8","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.pjnns.2016.01.002","article-title":"Surgery for sporadic vestibular schwannoma. Part II. Complications (not related to facial and auditory nerves)","volume":"50","author":"P Kunert","year":"2016","journal-title":"Neurol Neurochir Pol"},{"issue":"02","key":"ref9","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1177\/0194599813512106","article-title":"Complications of surgery for sporadic vestibular schwannoma","volume":"150","author":"H Mahboubi","year":"2014","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"01","key":"ref10","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1177\/0194599816677522","article-title":"Outcomes of vestibular schwannoma surgery among the elderly","volume":"156","author":"M J Sylvester","year":"2017","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"11","key":"ref11","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.3109\/00016481003762316","article-title":"Perioperative complications after translabyrinthine removal of large or giant vestibular schwannoma: outcomes for 123 patients","volume":"130","author":"A Charpiot","year":"2010","journal-title":"Acta Otolaryngol"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"e950","DOI":"10.1016\/j.wneu.2018.08.195","article-title":"Perioperative risk factors for thirty-day morbidity and mortality in the resection of extradural thoracic spine tumors","volume":"120","author":"E H Hersh","year":"2018","journal-title":"World Neurosurg"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"e294","DOI":"10.1016\/j.wneu.2018.07.136","article-title":"Clinical risk factors and postoperative complications associated with unplanned hospital readmissions after cranial neurosurgery","volume":"119","author":"C Lopez Ramos","year":"2018","journal-title":"World Neurosurg"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"e348","DOI":"10.1016\/j.wneu.2018.01.046","article-title":"Preoperative hemoglobin level is associated with increased health care use after elective spinal fusion (\u22653 levels) in elderly male patients with spine deformity","volume":"112","author":"A A Elsamadicy","year":"2018","journal-title":"World Neurosurg"},{"issue":"10","key":"ref15","doi-asserted-by":"crossref","first-page":"E1338","DOI":"10.1097\/BSD.0000000000000349","article-title":"Impact of anemia and transfusion on readmission and length of stay after spinal surgery: a single-center study of 1187 operations","volume":"30","author":"R Khanna","year":"2017","journal-title":"Clin Spine Surg"},{"issue":"08","key":"ref16","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1177\/2192568217705654","article-title":"Impact of preoperative anemia on outcomes in adults undergoing elective posterior cervical fusion","volume":"7","author":"K Phan","year":"2017","journal-title":"Global Spine J"},{"issue":"S 01","key":"ref17","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1111\/anae.13304","article-title":"Pre-operative haematological assessment in patients scheduled for major surgery","volume":"71","author":"M Mu\u00f1oz","year":"2016","journal-title":"Anaesthesia"},{"issue":"01","key":"ref18","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1093\/bja\/aeq361","article-title":"Detection, evaluation, and management of preoperative anaemia in the elective orthopaedic surgical patient: NATA guidelines","volume":"106","author":"L T Goodnough","year":"2011","journal-title":"Br J Anaesth"},{"issue":"03","key":"ref19","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1097\/00129492-200405000-00030","article-title":"The incidence of cerebrospinal fluid leak after vestibular schwannoma surgery","volume":"25","author":"S H Selesnick","year":"2004","journal-title":"Otol Neurotol"},{"issue":"02","key":"ref20","doi-asserted-by":"crossref","first-page":"347","DOI":"10.3171\/JNS-07\/08\/0347","article-title":"Reduction of cerebrospinal fluid rhinorrhea after vestibular schwannoma surgery by reconstruction of the drilled porus acusticus with hydroxyapatite bone cement","volume":"107","author":"C J Baird","year":"2007","journal-title":"J Neurosurg"},{"issue":"01","key":"ref21","doi-asserted-by":"crossref","first-page":"113","DOI":"10.3171\/2012.11.JNS121365","article-title":"Prevention of postoperative cerebrospinal fluid leaks with multilayered reconstruction using titanium mesh-hydroxyapatite cement cranioplasty after translabyrinthine resection of acoustic neuroma","volume":"119","author":"S Manjila","year":"2013","journal-title":"J Neurosurg"},{"issue":"04","key":"ref22","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1097\/mao.0b013e3180423ad9","article-title":"Hydroxyapatite cement cranioplasty in translabyrinthine acoustic neuroma surgery-update","volume":"28","author":"M A Arriaga","year":"2007","journal-title":"Otol Neurotol"},{"issue":"02","key":"ref23","doi-asserted-by":"crossref","first-page":"217","DOI":"10.3171\/jns.2001.94.2.0217","article-title":"Cerebrospinal fluid leak after acoustic neuroma surgery: influence of tumor size and surgical approach on incidence and response to treatment","volume":"94","author":"J W Brennan","year":"2001","journal-title":"J Neurosurg"},{"issue":"01","key":"ref24","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1097\/00129492-200301000-00021","article-title":"Cerebrospinal fluid leak after acoustic neuroma surgery: a comparison of the translabyrinthine, middle fossa, and retrosigmoid approaches","volume":"24","author":"S S Becker","year":"2003","journal-title":"Otol Neurotol"}],"container-title":["Journal of Neurological Surgery Part B: Skull Base"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0039-1692478.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,1,7]],"date-time":"2021-01-07T07:18:08Z","timestamp":1610003888000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0039-1692478"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6,21]]},"references-count":24,"journal-issue":{"issue":"05","published-online":{"date-parts":[[2020,10,27]]},"published-print":{"date-parts":[[2020,10]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0039-1692478","relation":{},"ISSN":["2193-6331","2193-634X"],"issn-type":[{"value":"2193-6331","type":"print"},{"value":"2193-634X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,6,21]]}}}