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Cerebrovascular procedures (CVPs) are complex and are often performed in patients with significant medical comorbidities.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>This study examines the impact of patient age and medical comorbidities on the occurrence of CMS-defined HACs, as well as the effect of these factors on the length of stay (LOS) and hospitalization charges in patients undergoing common CVPs.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>The HACs occurred at a frequency of 0.49% (1.33% in the intracranial procedures and 0.33% in the carotid procedures). Falls\/trauma (n = 4610, 72.3% HACs, 357 HACs per 100,000 CVPs) and catheter-associated urinary tract infections (n = 714, 11.2% HACs, 55 HACs per 100,000 CVPs) were the most common events. Age and the presence of \u2265 2 comorbidities were strong independent predictors of HACs (p &lt; 0.0001). The occurrence of HACs negatively impacts both LOS and hospital costs. Patients with at least 1 HAC were 10 times more likely to have prolonged LOS (\u2265 90th percentile) (p &lt; 0.0001), and 8 times more likely to have high inpatient costs (\u2265 90th percentile) (p &lt; 0.0001) when adjusting for patient and hospital factors.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Improved quality protocols focused on individual patient characteristics might help to decrease the frequency of HACs in this high-risk population. These data suggest that risk adjustment according to underlying patient factors may be warranted when considering reimbursement for costs related to HACs in the setting of CVPs.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2014.4.jns131253","type":"journal-article","created":{"date-parts":[[2014,6,27]],"date-time":"2014-06-27T13:57:49Z","timestamp":1403877469000},"page":"580-586","source":"Crossref","is-referenced-by-count":23,"title":["The impact of patient age and comorbidities on the occurrence of \u201cnever events\u201d in cerebrovascular surgery: an analysis of the Nationwide Inpatient Sample"],"prefix":"10.3171","volume":"121","author":[{"given":"Timothy","family":"Wen","sequence":"first","affiliation":[{"name":"Zilkha Neurogenetic Institute,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuhan","family":"He","sequence":"additional","affiliation":[{"name":"Zilkha Neurogenetic 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