{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T23:22:33Z","timestamp":1782516153402,"version":"3.54.5"},"reference-count":29,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2012,4]]},"abstract":"\nObject<\/jats:title>\nSurgical mortality is a frequent outcome measure in studies of volume-outcome relationships, and the Agency for Healthcare Research and Quality has endorsed surgical mortality after craniotomies as an Inpatient Quality Indicator. Still, the frequency and causes of 30-day mortality after neurosurgical procedures have not been much explored. The authors sought to study the frequency and possible causes of death following primary intracranial tumor operations. They also sought to explore a possible predictive value of perioperative mortality rates from neurosurgical centers in relation to long-term survival.<\/jats:p><\/jats:sec>\n\nMethods<\/jats:title>\nUsing population-based data from the Norwegian cancer registry, the authors identified 15,918 primary operations for primary CNS tumors treated in Norway in the period from August 1955 through December 2008. Patients were followed up until death, emigration, or September 2009. Causes of mortality as indicated on death certificates were studied. Factors associated with an increased risk of perioperative death were identified.<\/jats:p><\/jats:sec>\n\nResults<\/jats:title>\nThe overall risk of perioperative death after first-time surgery for primary intracranial tumors is currently 2.2% and has decreased over the last decades. An age \u2265 70 years and histopathological entities with poor long-term prognoses are risk factors. Overlapping lesions are also associated with excess risk, indicating that lesion size or multifocality may matter. The overall risk of perioperative death is also higher in biopsy cases than in resection cases. Perioperative mortality rates of the 4 Norwegian neurosurgical centers were not predictive of their respective long-term survival rates.<\/jats:p><\/jats:sec>\n\nConclusions<\/jats:title>\nAlthough considered surgically related if they occur within the first 30 days of surgery, most early postoperative deaths can happen independent of the handiwork of the operating surgeon or anesthesiologist. Overall prognosis of the disease seems to be a strong predictor of perioperative death\u2014perhaps not surprisingly since the 30-day mortality rate is merely the intonation of the Kaplan-Meier curve. Both referral and treatment policies at a neurosurgical center will therefore markedly affect such early outcomes, but early deaths may not necessarily reflect overall quality of care or long-term results. The low incidence of perioperative death in intracranial tumor surgery also greatly limits the statistical power in comparative analyses, such as between published patient series or between centers and certainly between surgeons. Therefore the authors question the value of perioperative mortality rates as a quality indicator in modern neurosurgery for tumors.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2011.12.jns11339","type":"journal-article","created":{"date-parts":[[2012,1,6]],"date-time":"2012-01-06T18:02:21Z","timestamp":1325872941000},"page":"825-834","source":"Crossref","is-referenced-by-count":42,"title":["Incidence and causes of perioperative mortality after primary surgery for intracranial tumors: a national, population-based study"],"prefix":"10.3171","volume":"116","author":[{"given":"Ole","family":"Solheim","sequence":"first","affiliation":[{"name":"Department of Neuroscience, Norwegian University of Science and Technology;"},{"name":"Department of Neurosurgery, St. Olavs University Hospital, Trondheim; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asgeir Store","family":"Jakola","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Norwegian University of Science and Technology;"},{"name":"Department of Neurosurgery, St. Olavs University Hospital, Trondheim; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sasha","family":"Gulati","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, St. Olavs University Hospital, Trondheim; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom B\u00f8rge","family":"Johannesen","sequence":"additional","affiliation":[{"name":"Cancer Registry of Norway, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns11339","series-title":"World J Surg","first-page":"2714","article-title":"Report of 2,087,915 surgical admissions in U.S. children: inpatient mortality rates by procedure and specialty","volume":"33","author":"Abdullah","year":"2009"},{"key":"b2-jns11339","series-title":"Anaesthesia","first-page":"1141","article-title":"Mortality associated with anaesthesia: a qualitative analysis to identify risk factors","volume":"56","author":"Arbous","year":"2001"},{"key":"b3-jns11339","series-title":"Cancer","first-page":"999","article-title":"Craniotomy for the resection of metastatic brain tumors in the U.S., 1988\u20132000: decreasing mortality and the effect of provider caseload","volume":"100","author":"Barker","year":"2004"},{"key":"b4-jns11339","series-title":"Laryngoscope","first-page":"1332","article-title":"Surgical excision of acoustic neuroma: patient outcome and provider caseload","volume":"113","author":"Barker","year":"2003"},{"key":"b5-jns11339","series-title":"Neuro Oncol","first-page":"49","article-title":"Surgery for primary supratentorial brain tumors in the United States, 1988 to 2000: the effect of provider caseload and centralization of care","volume":"7","author":"Barker","year":"2005"},{"key":"b6-jns11339","series-title":"J Clin Endocrinol Metab","first-page":"4709","article-title":"Transsphenoidal surgery for pituitary tumors in the United States, 1996\u20132000: mortality, morbidity, and the effects of hospital and surgeon volume","volume":"88","author":"Barker","year":"2003"},{"key":"b7-jns11339","series-title":"Med Care","first-page":"1117","article-title":"Comparison of in-hospital versus 30-day mortality assessments for selected medical conditions","volume":"48","author":"Borzecki","year":"2010"},{"key":"b8-jns11339","series-title":"Neurosurgery","first-page":"48","article-title":"The impact of provider volume on mortality after intracranial tumor resection","volume":"52","author":"Cowan","year":"2003"},{"key":"b9-jns11339","series-title":"J Neurosurg","first-page":"977","article-title":"Craniotomy for meningioma in the United States between 1988 and 2000: decreasing rate of mortality and the effect of provider caseload","volume":"102","author":"Curry","year":"2005"},{"key":"b10-jns11339","series-title":"JAMA","first-page":"847","article-title":"Surgical mortality as an indicator of hospital quality: the problem with small sample size","volume":"292","author":"Dimick","year":"2004"},{"key":"b11-jns11339","series-title":"Med Care","first-page":"8","article-title":"Comorbidity measures for use with administrative data","volume":"36","author":"Elixhauser","year":"1998"},{"key":"b12-jns11339","series-title":"Ther Clin Risk Manag","first-page":"681","article-title":"Postoperative mortality after inpatient surgery: incidence and risk factors","volume":"4","author":"Fecho","year":"2008"},{"key":"b13-jns11339","series-title":"Med Care","first-page":"112","article-title":"Impact of the present-on-admission indicator on hospital quality measurement: experience with the Agency for Healthcare Research and Quality (AHRQ) Inpatient Quality Indicators","volume":"46","author":"Glance","year":"2008"},{"key":"b14-jns11339","series-title":"CA Cancer J Clin","first-page":"192","article-title":"The effect of provider case volume on cancer mortality: systematic review and meta-analysis","volume":"59","author":"Gruen","year":"2009"},{"key":"b15-jns11339","series-title":"J Neurosurg","first-page":"257","article-title":"Neurosurgical mortality rates: what variables affect mortality within a single institution and within a national database? 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A review of the published literature and analysis of current original data","volume":"97","author":"Lagasse","year":"2002"},{"key":"b22-jns11339","series-title":"Eur J Cancer","first-page":"1218","article-title":"Data quality at the Cancer Registry of Norway: an overview of comparability, completeness, validity and timeliness","volume":"45","author":"Larsen","year":"2009"},{"key":"b23-jns11339","series-title":"Anesthesiology","first-page":"1087","article-title":"Survey of anesthesia-related mortality in France","volume":"105","author":"Lienhart","year":"2006"},{"key":"b24-jns11339","series-title":"Neurosurgery","first-page":"3","article-title":"The genesis of neurosurgery and the evolution of the neurosurgical operative environment: part Iprehistory to 2003","volume":"52","author":"Liu","year":"2003"},{"key":"b25-jns11339","series-title":"Neurosurgery","first-page":"1056","article-title":"Outcome and cost of craniotomy performed to treat tumors in regional academic referral centers","volume":"52","author":"Long","year":"2003"},{"key":"b26-jns11339","series-title":"Acta Neuropathol","first-page":"97","article-title":"The 2007 WHO classification of tumours of the central nervous system","volume":"114","author":"Louis","year":"2007"},{"key":"b27-jns11339","series-title":"Anesthesiology","first-page":"1105","article-title":"Postoperative mortality in The Netherlands: a population-based analysis of surgery-specific risk in adults","volume":"112","author":"Noordzij","year":"2010"},{"key":"b28-jns11339","series-title":"Neurosurgery","first-page":"553","article-title":"Craniotomy for resection of pediatric brain tumors in the United States, 1988 to 2000: effects of provider caseloads and progressive centralization and specialization of care","volume":"54","author":"Smith","year":"2004"},{"key":"b29-jns11339","series-title":"Neurosurg Rev","first-page":"115","article-title":"Surgical treatment for brain metastases: prognostic factors and survival in 177 patients","volume":"28","author":"Stark","year":"2005"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/116\/4\/article-p825.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/116\/4\/article-p825.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/116\/4\/article-p825.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T01:20:46Z","timestamp":1679880046000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/116\/4\/article-p825.xml"}},"subtitle":["Clinical article"],"short-title":[],"issued":{"date-parts":[[2012,4]]},"references-count":29,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3171\/2011.12.jns11339","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,4]]}}}