{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:50:12Z","timestamp":1786125012187,"version":"build-2736575974"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["NEUROSURGERY","NEUROS"],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:bold>BACKGROUND:<\/jats:bold>\n                    Neurological deterioration and mortality are frequent in neurosurgical patients transferred to tertiary centers, but the precise predictors leading to them are unclear.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>OBJECTIVE:<\/jats:bold>\n                    To analyze and quantify risk factors predicting deterioration and death in neurosurgery transfers.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>METHODS:<\/jats:bold>\n                    A consecutive review of all transfers with cranial pathology to a tertiary academic neurosurgery service was performed over a 2-year period. Risk factors including demographics, medical comorbidities, hydrocephalus, anticoagulant use, transfer diagnosis, Glasgow Coma Scale score, and transfer time were reviewed.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>RESULTS:<\/jats:bold>\n                    A total of 1429 transfers were studied, including 154 (10.8%) instances of neurological decline in transit and 99 mortalities (6.9%). On multivariate analysis, significant predictors of decline were hydrocephalus (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = .005, odds ratio [OR] 2) and use of clopidogrel (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = .003, OR 4.3), warfarin (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = .004, OR 2.6), or other systemic anticoagulants (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; .001, OR 10.1). Age (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = .004), hydrocephalus (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = .006, OR 2.1), renal failure (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = .05, OR 2.3), and use of clopidogrel (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = .003, OR 4.6) or warfarin (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = .03, OR 2.3) were found to be predictive of death. Analysis by transfer diagnosis found patients with intracerebral hemorrhage had the highest incidence of mortality (12.7%,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = .003, OR 2). Patients who ultimately died were transferred faster than survivors, but this did not achieve significance.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>CONCLUSION:<\/jats:bold>\n                    Neurosurgery patients are vulnerable to deterioration in transit and exhibit several patterns predictive of mortality. Hydrocephalus, use of clopidogrel and warfarin, and intracerebral hemorrhage are each independently associated with elevated risk of deterioration and death.\n                  <\/jats:p>","DOI":"10.1093\/neuros\/nyx012","type":"journal-article","created":{"date-parts":[[2017,1,30]],"date-time":"2017-01-30T08:27:36Z","timestamp":1485764856000},"page":"240-250","source":"Crossref","is-referenced-by-count":12,"title":["Neurosurgical Emergency Transfers: An Analysis of Deterioration and Mortality"],"prefix":"10.1227","volume":"81","author":[{"given":"Ali","family":"Alaraj","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darian R.","family":"Esfahani","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed E.","family":"Hussein","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioana","family":"Darie","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sepideh","family":"Amin-Hanjani","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantin V.","family":"Slavin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinjian","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fady T.","family":"Charbel","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2017,8]]},"reference":[{"issue":"2","key":"bib1-20231011","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1227\/NEU.0000000000000752","article-title":"Interhospital transfer of neurosurgical patients to a high-volume tertiary care center: opportunities for improvement","volume":"77","author":"Holland","year":"2015","journal-title":"Neurosurgery"},{"issue":"3","key":"bib2-20231011","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1227\/01.neu.0000317320.79106.7e","article-title":"Neurosurgical emergency transfers to academic centers in Cook County: a prospective multicenter 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