{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T09:05:10Z","timestamp":1780131910589,"version":"3.54.0"},"reference-count":68,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2014,11]]},"abstract":"\n Object<\/jats:title>\n Treatment of craniopharyngiomas is one of the most demanding and controversial neurosurgical procedures performed. The authors sought to determine the factors associated with hospital charges and fees for craniopharyngioma treatment to identify possible opportunities for improving the health care economics of inpatient care.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The authors analyzed the hospital discharge database of the Nationwide Inpatient Sample (NIS) covering the period from 2007 through 2011 to examine national treatment trends for adults (that is, those older than 18 years) who had undergone surgery for craniopharyngioma. To predict the drivers of in-hospital charges, a multistep regression model was developed that accounted for patient demographics, acuity measures, comorbidities, hospital characteristics, and complications.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The analysis included 606 patients who underwent resection of craniopharyngioma; 353 resections involved a transsphenoidal approach (58%) and 253 a transfrontal approach (42%). The mean age (\u00b1 SD) of patients was 47.7 \u00b1 16.3 years. The average hospital length of stay (LOS) was 7.6 \u00b1 9 days. The mean hospital charge (\u00b1 SD) was $92,300 \u00b1 $83,356. In total, 48% of the patients experienced postoperative diabetes insipidus or an electrolyte abnormality. A multivariate regression model demonstrated that LOS, hospital volume for the selected procedure, the surgical approach, postoperative complications, comorbidities, and year of surgery were all significant predictors of in-hospital charges. The statistical model accounted for 54% of the variance in in-hospital charge.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This analysis of inpatient hospital charges in patients undergoing craniopharyngioma surgery identified key drivers of charges in the perioperative period. Prospective studies designed to evaluate the long-term resource utilization in this complex patient population would be a useful future direction.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2014.8.focus14366","type":"journal-article","created":{"date-parts":[[2014,11,1]],"date-time":"2014-11-01T04:36:15Z","timestamp":1414816575000},"page":"E6","source":"Crossref","is-referenced-by-count":21,"title":["National treatment trends, complications, and predictors of in-hospital charges for the surgical management of craniopharyngiomas in adults from 2007 to 2011"],"prefix":"10.3171","volume":"37","author":[{"given":"Hasan A.","family":"Zaidi","sequence":"first","affiliation":[{"name":"Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Chapple","sequence":"additional","affiliation":[{"name":"Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew S.","family":"Little","sequence":"additional","affiliation":[{"name":"Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-focus14366","series-title":"Cochrane Database Syst Rev","first-page":"CD005391","article-title":"Workload and surgeon's specialty for outcome after colorectal cancer surgery","volume":"3","author":"Archampong","year":"2012"},{"key":"b2-focus14366","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":"b3-focus14366","series-title":"JAMA","first-page":"1747","article-title":"Impact of hospital volume on operative mortality for major cancer surgery","volume":"280","author":"Begg","year":"1998"},{"key":"b4-focus14366","series-title":"J Neurosurg","first-page":"547","article-title":"The descriptive epidemiology of craniopharyngioma","volume":"89","author":"Bunin","year":"1998"},{"key":"b5-focus14366","series-title":"Neurol Res","first-page":"442","article-title":"Persistent outpatient hyperglycemia is independently associated with survival, recurrence and malignant degeneration following surgery for hemispheric low grade gliomas","volume":"32","author":"Chaichana","year":"2010"},{"key":"b6-focus14366","series-title":"Neuro Oncol","first-page":"159","article-title":"Stereotactic radiosurgery of residual or recurrent craniopharyngioma, after surgery, with or without radiation therapy","volume":"3","author":"Chiou","year":"2001"},{"key":"b7-focus14366","series-title":"Obes Surg","first-page":"1008","article-title":"The relationship between volume and outcome after bariatric surgery: a nationwide study in Taiwan","volume":"22","author":"Chiu","year":"2012"},{"key":"b8-focus14366","series-title":"Spine (Phila Pa 1976)","first-page":"1498","article-title":"Incidence and cost of treating axis fractures in the United States from 2000 to 2010","volume":"39","author":"Daniels","year":"2014"},{"key":"b9-focus14366","series-title":"Surg Neurol Int","first-page":"7","article-title":"A review of interspinous fusion devices: high complication, reoperation rates, and costs with poor outcomes","volume":"3","author":"Epstein","year":"2012"},{"key":"b10-focus14366","series-title":"Spine (Phila Pa 1976)","first-page":"905","article-title":"Surgeon choices, and the choice of surgeons, affect total hospital charges for single-level anterior cervical surgery","volume":"36","author":"Epstein","year":"2011"},{"key":"b11-focus14366","series-title":"Laryngoscope","first-page":"543","article-title":"National trends in oropharyngeal cancer surgery and the effect of surgeon and hospital volume on shortterm outcomes and cost of care","volume":"122","author":"Gourin","year":"2012"},{"key":"b12-focus14366","series-title":"J Clin Oncol","first-page":"2327","article-title":"Hospital and physician volume or specialization and outcomes in cancer treatment: importance in quality of cancer care","volume":"18","author":"Hillner","year":"2000"},{"key":"b13-focus14366","series-title":"Neurosurgery","first-page":"614","article-title":"The effect of coiling versus clipping of ruptured and unruptured cerebral aneurysms on length of stay, hospital cost, hospital reimbursement, and surgeon reimbursement at the university of Florida","volume":"64","author":"Hoh","year":"2009"},{"key":"b14-focus14366","series-title":"Stroke","first-page":"337","article-title":"Length of stay and total hospital charges of clipping versus coiling for ruptured and unruptured adult cerebral aneurysms in the Nationwide Inpatient Sample database 2002 to 2006","volume":"41","author":"Hoh","year":"2010"},{"key":"b15-focus14366","series-title":"Ann Thorac Surg","first-page":"1992","article-title":"Relative impact of surgeon and center volume on early mortality after the Norwood operation","volume":"93","author":"Hornik","year":"2012"},{"key":"b16-focus14366","series-title":"Healthcare Cost and Utilization Project","article-title":"Using the HCUP Nationwide Inpatient Sample to estimate trends (updated for 1988-2004). HCUP Methods Series Report #2006-05","author":"Houchens"},{"key":"b17-focus14366","series-title":"J Clin Neurosci","first-page":"1621","article-title":"The therapeutic efficacy of fractionated radiotherapy and gammaknife radiosurgery for craniopharyngiomas","volume":"18","author":"Jeon","year":"2011"},{"key":"b18-focus14366","series-title":"Clin Endocrinol (Oxf)","first-page":"397","article-title":"Craniopharyngiomas in children and adults: systematic analysis of 121 cases with long-term follow-up","volume":"62","author":"Karavitaki","year":"2005"},{"key":"b19-focus14366","series-title":"Scand J Surg","first-page":"66","article-title":"Surgical safety checklist is associated with improved operating room safety culture, reduced wound complications and unplanned readmissions in a pilot study in neurosurgery","volume":"103","author":"Lep\u00e4nluoma","year":"2014"},{"key":"b20-focus14366","series-title":"Spine (Phila Pa 1976)","first-page":"2905","article-title":"Comparative charge analysis of one- and two-level lumbar total disc arthroplasty versus circumferential lumbar fusion","volume":"32","author":"Levin","year":"2007"},{"key":"b21-focus14366","series-title":"J Clin Neurosci","first-page":"996","article-title":"Hyperglycemia is independently associated with post-operative function loss in patients with primary eloquent glioblastoma","volume":"19","author":"Link","year":"2012"},{"key":"b22-focus14366","series-title":"J Neurosurg","first-page":"504","article-title":"Predictors of resource utilization in transsphenoidal surgery for Cushing disease. Clinical article","volume":"119","author":"Little","year":"2013"},{"key":"b23-focus14366","series-title":"Neurosurgery","first-page":"286","article-title":"Persistent outpatient hyperglycemia is independently associated with decreased survival after primary resection of malignant brain astrocytomas","volume":"63","author":"McGirt","year":"2008"},{"key":"b24-focus14366","series-title":"Crit Rev Oncol Hematol","first-page":"514","article-title":"Surgical strategies and modern therapeutic options in the treatment of craniopharyngiomas","volume":"88","author":"Mortini","year":"2013"},{"key":"b25-focus14366","series-title":"Eur J Endocrinol","first-page":"259","article-title":"Predictors of access to pituitary tumor resection in the United States, 1988\u20132005","volume":"161","author":"Mukherjee","year":"2009"},{"key":"b26-focus14366","series-title":"Childs Nerv Syst","first-page":"305","article-title":"Variations in referral patterns for hypophysectomies among pediatric patients with sellar and parasellar tumors","volume":"26","author":"Mukherjee","year":"2010"},{"issue":"3","key":"b27-focus14366","series-title":"Neurosurg Focus","first-page":"E7","article-title":"National trends, complications, and outcomes following transsphenoidal surgery for Cushing's disease from 1993 to 2002","volume":"23","author":"Patil","year":"2007"},{"key":"b28-focus14366","series-title":"Am J Surg Pathol","first-page":"1020","article-title":"The spectrum of malignancy in craniopharyngioma","volume":"31","author":"Rodriguez","year":"2007"},{"key":"b29-focus14366","series-title":"Clin Neurol Neurosurg","first-page":"55","article-title":"Practice patterns of in-hospital surgical treatment of trigeminal neuralgia from 1988 to 2010","volume":"120","author":"Rosenbaum","year":"2014"},{"key":"b30-focus14366","series-title":"World Neurosurg","first-page":"270","article-title":"A role for centers of excellence in transsphenoidal surgery","volume":"80","author":"Schwartz","year":"2013"},{"key":"b31-focus14366","series-title":"Childs Nerv Syst","first-page":"729","article-title":"Craniopharyngiomas in children: surgical experience at Children's Memorial Hospital","volume":"21","author":"Tomita","year":"2005"},{"key":"b32-focus14366","series-title":"J Neurosurg Spine","first-page":"694","article-title":"An analysis of the differences in the acute hospitalization charges following minimally invasive versus open posterior lumbar interbody fusion. Clinical article","volume":"12","author":"Wang","year":"2010"},{"key":"b33-focus14366","series-title":"Neurosurgery","first-page":"860","article-title":"Performing a cost analysis in spine outcomes research: comparing ventral and dorsal approaches for cervical spondylotic myelopathy","volume":"70","author":"Whitmore","year":"2012"},{"key":"b34-focus14366","series-title":"Neurosurgery","first-page":"99","article-title":"Predictors of ambulatory function after surgical resection of intramedullary spinal cord tumors","volume":"61","author":"Woodworth","year":"2007"},{"key":"b1-focus14366","series-title":"Cochrane Database Syst Rev","first-page":"CD005391","article-title":"Workload and surgeon's specialty for outcome after colorectal cancer surgery","volume":"3","author":"Archampong","year":"2012"},{"key":"b2-focus14366","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":"b3-focus14366","series-title":"JAMA","first-page":"1747","article-title":"Impact of hospital volume on operative mortality for major cancer surgery","volume":"280","author":"Begg","year":"1998"},{"key":"b4-focus14366","series-title":"J Neurosurg","first-page":"547","article-title":"The descriptive epidemiology of craniopharyngioma","volume":"89","author":"Bunin","year":"1998"},{"key":"b5-focus14366","series-title":"Neurol Res","first-page":"442","article-title":"Persistent outpatient hyperglycemia is independently associated with survival, recurrence and malignant degeneration following surgery for hemispheric low grade gliomas","volume":"32","author":"Chaichana","year":"2010"},{"key":"b6-focus14366","series-title":"Neuro Oncol","first-page":"159","article-title":"Stereotactic radiosurgery of residual or recurrent craniopharyngioma, after surgery, with or without radiation therapy","volume":"3","author":"Chiou","year":"2001"},{"key":"b7-focus14366","series-title":"Obes Surg","first-page":"1008","article-title":"The relationship between volume and outcome after bariatric surgery: a nationwide study in Taiwan","volume":"22","author":"Chiu","year":"2012"},{"key":"b8-focus14366","series-title":"Spine (Phila Pa 1976)","first-page":"1498","article-title":"Incidence and cost of treating axis fractures in the United States from 2000 to 2010","volume":"39","author":"Daniels","year":"2014"},{"key":"b9-focus14366","series-title":"Surg Neurol Int","first-page":"7","article-title":"A review of interspinous fusion devices: high complication, reoperation rates, and costs with poor outcomes","volume":"3","author":"Epstein","year":"2012"},{"key":"b10-focus14366","series-title":"Spine (Phila Pa 1976)","first-page":"905","article-title":"Surgeon choices, and the choice of surgeons, affect total hospital charges for single-level anterior cervical surgery","volume":"36","author":"Epstein","year":"2011"},{"key":"b11-focus14366","series-title":"Laryngoscope","first-page":"543","article-title":"National trends in oropharyngeal cancer surgery and the effect of surgeon and hospital volume on shortterm outcomes and cost of care","volume":"122","author":"Gourin","year":"2012"},{"key":"b12-focus14366","series-title":"J Clin Oncol","first-page":"2327","article-title":"Hospital and physician volume or specialization and outcomes in cancer treatment: importance in quality of cancer care","volume":"18","author":"Hillner","year":"2000"},{"key":"b13-focus14366","series-title":"Neurosurgery","first-page":"614","article-title":"The effect of coiling versus clipping of ruptured and unruptured cerebral aneurysms on length of stay, hospital cost, hospital reimbursement, and surgeon reimbursement at the university of Florida","volume":"64","author":"Hoh","year":"2009"},{"key":"b14-focus14366","series-title":"Stroke","first-page":"337","article-title":"Length of stay and total hospital charges of clipping versus coiling for ruptured and unruptured adult cerebral aneurysms in the Nationwide Inpatient Sample database 2002 to 2006","volume":"41","author":"Hoh","year":"2010"},{"key":"b15-focus14366","series-title":"Ann Thorac Surg","first-page":"1992","article-title":"Relative impact of surgeon and center volume on early mortality after the Norwood operation","volume":"93","author":"Hornik","year":"2012"},{"key":"b16-focus14366","series-title":"Healthcare Cost and Utilization Project","article-title":"Using the HCUP Nationwide Inpatient Sample to estimate trends (updated for 1988-2004). HCUP Methods Series Report #2006-05","author":"Houchens"},{"key":"b17-focus14366","series-title":"J Clin Neurosci","first-page":"1621","article-title":"The therapeutic efficacy of fractionated radiotherapy and gammaknife radiosurgery for craniopharyngiomas","volume":"18","author":"Jeon","year":"2011"},{"key":"b18-focus14366","series-title":"Clin Endocrinol (Oxf)","first-page":"397","article-title":"Craniopharyngiomas in children and adults: systematic analysis of 121 cases with long-term follow-up","volume":"62","author":"Karavitaki","year":"2005"},{"key":"b19-focus14366","series-title":"Scand J Surg","first-page":"66","article-title":"Surgical safety checklist is associated with improved operating room safety culture, reduced wound complications and unplanned readmissions in a pilot study in neurosurgery","volume":"103","author":"Lep\u00e4nluoma","year":"2014"},{"key":"b20-focus14366","series-title":"Spine (Phila Pa 1976)","first-page":"2905","article-title":"Comparative charge analysis of one- and two-level lumbar total disc arthroplasty versus circumferential lumbar fusion","volume":"32","author":"Levin","year":"2007"},{"key":"b21-focus14366","series-title":"J Clin Neurosci","first-page":"996","article-title":"Hyperglycemia is independently associated with post-operative function loss in patients with primary eloquent glioblastoma","volume":"19","author":"Link","year":"2012"},{"key":"b22-focus14366","series-title":"J Neurosurg","first-page":"504","article-title":"Predictors of resource utilization in transsphenoidal surgery for Cushing disease. Clinical article","volume":"119","author":"Little","year":"2013"},{"key":"b23-focus14366","series-title":"Neurosurgery","first-page":"286","article-title":"Persistent outpatient hyperglycemia is independently associated with decreased survival after primary resection of malignant brain astrocytomas","volume":"63","author":"McGirt","year":"2008"},{"key":"b24-focus14366","series-title":"Crit Rev Oncol Hematol","first-page":"514","article-title":"Surgical strategies and modern therapeutic options in the treatment of craniopharyngiomas","volume":"88","author":"Mortini","year":"2013"},{"key":"b25-focus14366","series-title":"Eur J Endocrinol","first-page":"259","article-title":"Predictors of access to pituitary tumor resection in the United States, 1988\u20132005","volume":"161","author":"Mukherjee","year":"2009"},{"key":"b26-focus14366","series-title":"Childs Nerv Syst","first-page":"305","article-title":"Variations in referral patterns for hypophysectomies among pediatric patients with sellar and parasellar tumors","volume":"26","author":"Mukherjee","year":"2010"},{"issue":"3","key":"b27-focus14366","series-title":"Neurosurg Focus","first-page":"E7","article-title":"National trends, complications, and outcomes following transsphenoidal surgery for Cushing's disease from 1993 to 2002","volume":"23","author":"Patil","year":"2007"},{"key":"b28-focus14366","series-title":"Am J Surg Pathol","first-page":"1020","article-title":"The spectrum of malignancy in craniopharyngioma","volume":"31","author":"Rodriguez","year":"2007"},{"key":"b29-focus14366","series-title":"Clin Neurol Neurosurg","first-page":"55","article-title":"Practice patterns of in-hospital surgical treatment of trigeminal neuralgia from 1988 to 2010","volume":"120","author":"Rosenbaum","year":"2014"},{"key":"b30-focus14366","series-title":"World Neurosurg","first-page":"270","article-title":"A role for centers of excellence in transsphenoidal surgery","volume":"80","author":"Schwartz","year":"2013"},{"key":"b31-focus14366","series-title":"Childs Nerv Syst","first-page":"729","article-title":"Craniopharyngiomas in children: surgical experience at Children's Memorial Hospital","volume":"21","author":"Tomita","year":"2005"},{"key":"b32-focus14366","series-title":"J Neurosurg Spine","first-page":"694","article-title":"An analysis of the differences in the acute hospitalization charges following minimally invasive versus open posterior lumbar interbody fusion. 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