{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T20:40:15Z","timestamp":1771706415434,"version":"3.50.1"},"reference-count":44,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2005,6]]},"abstract":"<jats:p content-type=\"fine-print\"><jats:italic>Object.<\/jats:italic> The goal of this study was to determine the risk of adverse outcomes after contemporary surgical treatment of meningiomas in the US and trends in patient outcomes and patterns of care.<\/jats:p>\n<jats:p content-type=\"fine-print\"><jats:italic>Methods.<\/jats:italic> The authors performed a retrospective cohort study by using the Nationwide Inpatient Sample covering the period of 1988 to 2000. Multivariate regression models with disposition end points of death and hospital discharge were used to test patient, surgeon, and hospital characteristics, including volume of care, as outcome predictors.<\/jats:p>\n<jats:p content-type=\"fine-print\">Multivariate analyses revealed that larger-volume centers had lower mortality rates for patients who underwent craniotomy for meningioma (odds ratio [OR] 0.74, 95% confidence interval [CI] 0.59\u20130.93, p = 0.01). Adverse discharge disposition was also less likely at high-volume hospitals (OR 0.71, 95% CI 0.62\u20130.80, p &lt; 0.001). With respect to the surgeon caseload, there was a trend toward a lower rate of mortality after surgery when higher-caseload providers were involved, and a significantly less frequent adverse discharge disposition (OR 0.71, 95% CI 0.62\u20130.80, p &lt;, 0.001).<\/jats:p>\n<jats:p content-type=\"fine-print\">The annual meningioma caseload in the US increased 83% between 1988 and 2000, from 3900 patients\/year to 7200 patients\/year. In-hospital mortality rates decreased 61%, from 4.5% in 1988 to 1.8% in 2000. Reductions in the mortality rates were largest at high-volume centers (a 72% reduction in the relative mortality rate at largest-volume-quintile centers, compared with a 6% increase in the relative mortality rate at lowest-volume-quintile centers). The number of US hospitals where craniotomies were performed for meningiomas increased slightly. Fewer centers hosted one meningioma resection annually, whereas the largest centers had disproportionate increases in their caseloads, indicating a modest centralization of meningioma surgery in the US during this interval.<\/jats:p>\n<jats:p content-type=\"fine-print\"><jats:italic>Conclusions.<\/jats:italic> The mortality and adverse hospital discharge disposition rates were lower when meningioma surgery was performed by high-volume providers. The annual US caseload increased, whereas the mortality rates decreased, especially at high-volume centers.<\/jats:p>","DOI":"10.3171\/jns.2005.102.6.0977","type":"journal-article","created":{"date-parts":[[2009,5,13]],"date-time":"2009-05-13T18:04:03Z","timestamp":1242237843000},"page":"977-986","source":"Crossref","is-referenced-by-count":94,"title":["Craniotomy for meningioma in the United States between 1988 and 2000: decreasing rate of mortality and the effect of provider caseload"],"prefix":"10.3171","volume":"102","author":[{"given":"William T.","family":"Curry","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael W.","family":"McDermott","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bob S.","family":"Carter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fred G.","family":"Barker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"AHRQ Quality Indicators\u2014Guide to Patient Safety Indicators.","year":"2003"},{"key":"b2","series-title":"Calculating Nationwide Inpatient Sample Variances, 2000.","year":"2002"},{"key":"b3","series-title":"Cancer","doi-asserted-by":"publisher","first-page":"999","DOI":"10.1002\/cncr.20058","article-title":"Craniotomy for the resection of metastatic brain tumors in the U.S., decreasing mortality and the effect of provider caseload. 1988\u20132000.","volume":"100","author":"Barker","year":"2004"},{"key":"b4","series-title":"Neuro-oncology","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1215\/S1152851704000146","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":"b5","series-title":"Neurosurgery","first-page":"995","article-title":"In-hospital mortality and morbidity after surgical treatment of unruptured intracranial aneurysms in the United States, 1996\u20132000: the effect of hospital and surgeon volume.","volume":"52","author":"Barker","year":"2003"},{"key":"b6","series-title":"Laryngoscope","doi-asserted-by":"publisher","first-page":"1332","DOI":"10.1097\/00005537-200308000-00013","article-title":"Surgical excision of acoustic neuroma: patient outcome and provider caseload.","volume":"113","author":"Barker","year":"2003"},{"key":"b7","series-title":"JAMA","doi-asserted-by":"publisher","first-page":"1747","DOI":"10.1001\/jama.280.20.1747","article-title":"Impact of hospital volume on operative mortality for major cancer surgery.","volume":"280","author":"Begg","year":"1998"},{"key":"b8","series-title":"J Am Coll Surg","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1016\/S1072-7515(01)01183-8","article-title":"Identifying patient preoperative risk factors and postoperative adverse events in administrative databases: results from the Department of Veterans Affairs National Surgical Quality Improvement Program.","volume":"194","author":"Best","year":"2002"},{"key":"b9","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"1128","DOI":"10.1056\/NEJMsa012337","article-title":"Hospital volume and surgical mortality in the United States.","volume":"346","author":"Birkmeyer","year":"2002"},{"key":"b10","series-title":"Berenson\u2014Eggers Type of Service (BETOS) Codes"},{"key":"b11","series-title":"Spine","doi-asserted-by":"publisher","first-page":"1201","DOI":"10.1097\/00007632-199405310-00001","article-title":"An international comparison of back surgery rates.","volume":"19","author":"Cherkin","year":"1994"},{"key":"b12","series-title":"Neurosurgery","first-page":"1027","article-title":"The impact of provider volume on mortality after intracranial tumor resection and outcome and cost of craniotomy performed to treat tumors in regional academic referral centers.","volume":"54","author":"Chernov","year":"2004"},{"key":"b13","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":"b14","series-title":"Meningiomas. 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