{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T12:42:12Z","timestamp":1763037732466,"version":"build-2065373602"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,4,5]],"date-time":"2022-04-05T00:00:00Z","timestamp":1649116800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To investigate the impact of facility volume on Patient Safety Indicator (PSI) events following transsphenoidal pituitary surgery (TSPS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective database review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>National Inpatient Sample database (2003\u20102011).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The National Inpatient Sample was queried for TSPS cases from 2003 to 2011. Facility volume was defined by tertile of average annual number of TSPS procedures performed. PSIs, based on in\u2010hospital complications identified by the Agency of Healthcare Research and Quality, and poor outcomes, such as mortality and tracheostomy, were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>An overall 16,039 cases were included: 804 had \u22651 PSI and 15,235 had none. A greater proportion of male to female (5.8% vs 4.3%) and Black to White (7.0% vs 4.5%) patients experienced PSIs. There was an increased likelihood of poor outcome (odds ratio [OR], 3.1 [95% CI, 2.5\u20103.7]; <jats:italic>P<\/jats:italic> &lt; .001) and mortality (OR, 30.1 [95% CI, 18.5\u201048.8]; <jats:italic>P<\/jats:italic> &lt; .001) with a PSI. The incidence rates of PSIs at low\u2010, intermediate\u2010, and high\u2010volume facilities were 5.7%, 5.1%, and 4.2%, respectively. Odds of poor outcome with PSIs were greater at low\u2010volume facilities (OR, 3.3 [95% CI, 2.4\u20104.4]; <jats:italic>P<\/jats:italic> &lt; .001) vs intermediate (OR, 3.1 [95% CI, 2.1\u20104.2]; <jats:italic>P<\/jats:italic> &lt; .001) and high (OR, 2.5 [95% CI, 1.7\u20103.8]; <jats:italic>P<\/jats:italic> &lt; .001). Odds of mortality with PSIs were greater at high\u2010volume facilities (OR, 43.0 [95% CI, 14.3\u2010129.4]; <jats:italic>P<\/jats:italic> &lt; .001) vs intermediate (OR, 40.0 [95% CI, 18.5\u201086.4]; <jats:italic>P<\/jats:italic> &lt; .001) and low (OR, 17.3 [95% CI, 8.0\u201037.7]; <jats:italic>P<\/jats:italic> &lt; .001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>PSIs were associated with a higher likelihood of poor outcome and mortality following TSPS. Patients who experienced PSIs had a lower risk of poor outcome but increased mortality at higher\u2010volume facilities.<\/jats:p><\/jats:sec>","DOI":"10.1177\/01945998221089826","type":"journal-article","created":{"date-parts":[[2022,4,5]],"date-time":"2022-04-05T12:02:38Z","timestamp":1649160158000},"page":"227-233","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Impact of Facility Volume on Patient Safety Indicator Events After Transsphenoidal Pituitary Surgery"],"prefix":"10.1002","volume":"168","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3352-552X","authenticated-orcid":false,"given":"Mehdi S.","family":"Lemdani","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Rutgers New Jersey Medical School  Newark New Jersey USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannaan S.","family":"Choudhry","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Rutgers New Jersey Medical School  Newark New Jersey USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher C.","family":"Tseng","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Rutgers New Jersey Medical School  Newark New Jersey USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina H.","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery, Montefiore Medical Center The University Hospital of Albert Einstein College of Medicine  Bronx New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donata","family":"Sukyte\u2010Raube","sequence":"additional","affiliation":[{"name":"Center of Ear, Nose, and Throat Diseases, Vilnius University Hospital Santaros Clinics Vilnius University  Vilnius Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prayag","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Rutgers New Jersey Medical School  Newark New Jersey USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2893-7818","authenticated-orcid":false,"given":"Jean Anderson","family":"Eloy","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Rutgers New Jersey Medical School  Newark New Jersey USA"},{"name":"Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey Rutgers New Jersey Medical School  Newark New Jersey USA"},{"name":"Department of Neurological Surgery Rutgers New Jersey Medical School  Newark New Jersey USA"},{"name":"Department of Ophthalmology and Visual Science Rutgers New Jersey Medical School  Newark New Jersey 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