{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:50:28Z","timestamp":1786125028619,"version":"build-2736575974"},"reference-count":7,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["NEUROSURGERY","NEUROS"],"published-print":{"date-parts":[[2017,2]]},"abstract":"Abstract<\/jats:title>\n \n BACKGROUND:<\/jats:bold>\n Overlapping surgery is a common practice to improve surgical efficiency, but there are limited data on its safety.\n <\/jats:p>\n \n OBJECTIVE:<\/jats:bold>\n To analyze the patient outcomes of overlapping vs nonoverlapping surgeries performed by multiple neurosurgeons.\n <\/jats:p>\n \n METHODS:<\/jats:bold>\n Retrospective review of 7358 neurosurgical procedures, 2012 to 2015, at an urban academic hospital. Collected variables: patient age, gender, insurance, American Society of Anesthesiologists score, severity of illness, mortality risk, admission type, transfer source, procedure type, surgery date, number of cosurgeons, presence of neurosurgery resident\/fellow\/another attending, and overlapping vs nonoverlapping surgery. Outcomes: procedure time, length of stay, estimated blood loss, discharge location, 30-day mortality, 30-day readmission, return to operating room, acute respiratory failure, and severe sepsis. Statistics: univariate, then multivariate mixed-effect models.\n <\/jats:p>\n \n RESULTS:<\/jats:bold>\n Overlapping surgery patients (n = 3725) were younger and had lower American Society of Anesthesiologists scores, severity of illness, and mortality risk (\n P<\/jats:italic>\n < .0001) than nonoverlapping surgery patients (n = 3633). Overlapping surgeries had longer procedure times (214 vs 172 min;\n P<\/jats:italic>\n < .0001), but shorter length of stay (7.3 vs 7.9 d;\n P<\/jats:italic>\n = .010) and lower estimated blood loss (312 vs 363 mL\u2019s;\n P<\/jats:italic>\n = .003). Overlapping surgery patients were more likely to be discharged home (73.6% vs 66.2%;\n P<\/jats:italic>\n < .0001), and had lower mortality rates (1.3% vs 2.5%;\n P<\/jats:italic>\n = .0005) and acute respiratory failure (1.8% vs 2.6%;\n P<\/jats:italic>\n = .021). In multivariate models, there was no significant difference between overlapping and nonoverlapping surgeries for any patient outcomes, except for procedure duration, which was longer in overlapping surgery (estimate = 23.03;\n P<\/jats:italic>\n < .001).\n <\/jats:p>\n \n CONCLUSIONS:<\/jats:bold>\n When planned appropriately, overlapping surgery can be performed safely within the infrastructure at our academic institution.\n <\/jats:p>","DOI":"10.1093\/neuros\/nyw067","type":"journal-article","created":{"date-parts":[[2017,1,5]],"date-time":"2017-01-05T15:05:55Z","timestamp":1483628755000},"page":"257-268","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":52,"title":["Comparison of Patient Outcomes in 3725 Overlapping vs 3633 Nonoverlapping Neurosurgical Procedures Using a Single Institution's Clinical and Administrative Database"],"prefix":"10.1227","volume":"80","author":[{"given":"Corinna C.","family":"Zygourakis","sequence":"first","affiliation":[{"name":"Department of Neurological Surg-ery"},{"name":"Center for Healthcare Value"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malla","family":"Keefe","sequence":"additional","affiliation":[{"name":"Department of Neurological Surg-ery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janelle","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Quality, UCSF Health, University of California, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julio","family":"Barba","sequence":"additional","affiliation":[{"name":"Department of Quality, UCSF Health, University of California, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael W.","family":"McDermott","sequence":"additional","affiliation":[{"name":"Department of Neurological Surg-ery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Praveen V.","family":"Mummaneni","sequence":"additional","affiliation":[{"name":"Department of Neurological Surg-ery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael T.","family":"Lawton","sequence":"additional","affiliation":[{"name":"Department of Neurological Surg-ery"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2017,2]]},"reference":[{"key":"bib3-20240906","year":"2016","journal-title":"Position Statement on Intraoperative Responsibility of Primary Neurosurgeon"},{"key":"bib4-20240906","author":"Abelson","year":"2015","journal-title":"Clash in the Name of Care"},{"issue":"6","key":"bib7-20240906","doi-asserted-by":"crossref","first-page":"1044","DOI":"10.1097\/SLA.0000000000001208","article-title":"Procedure delegation by attending surgeons performing concurrent operations in academic medical centers: balancing safety and efficiency","volume":"261","author":"Beasley","year":"2015","journal-title":"Ann Surg"},{"key":"bib9-20240906","article-title":"Attendings\u2019 performing simultaneous operations in academic cardiothoracic surgery does not increase operative duration or negatively affect patient outcomes","author":"Yount","year":"2016","journal-title":"Paper presented at: American Association of Thoracic Surgeons annual meeting"},{"key":"bib10-20240906","article-title":"Performing concurrent operations in academic vascular neurosurgery does not affect patient outcomes","author":"Zygourakis","year":"2016","journal-title":"J Neurosurg"},{"issue":"1","key":"bib11-20240906","first-page":"1","article-title":"Basilar apex aneurysms: surgical results and perspectives from an initial experience","volume":"50","author":"Lawton","year":"2002","journal-title":"Neurosurgery"},{"issue":"7","key":"bib12-20240906","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1001\/jamasurg.2016.0511","article-title":"Concurrent surgery and informed consent","volume":"151","author":"Langerman","year":"2016","journal-title":"JAMA Surg"}],"container-title":["Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/00006123-201702000-00010","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:49:10Z","timestamp":1786121350000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00006123-201702000-00010"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,1,10]]},"references-count":7,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2017]]}},"URL":"https:\/\/doi.org\/10.1093\/neuros\/nyw067","relation":{},"ISSN":["0148-396X","1524-4040"],"issn-type":[{"value":"0148-396X","type":"print"},{"value":"1524-4040","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,1,10]]},"assertion":[{"value":"2016-06-08","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-10-03","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}