The cost of a plastic surgery team assisting with cranioplasty

Cranioplasty is a commonly performed neurosurgical procedure that restores cranial anatomy. While plastic surgeons are commonly involved with cranioplasties, the cost of performing a cranioplasty with neurosurgery alone (N) vs. neurosurgery and plastic surgery (N + P) is unknown. A single-center, mu...

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Published in:Clinical neurology and neurosurgery 2023-05, Vol.228, p.107711-107711, Article 107711
Main Authors: Dambrino, Robert J., Liles, D. Campbell, Chen, Jeffrey W., Chanbour, Hani, Koester, Stefan W., Feldman, Michael J., Chitale, Rohan V., Morone, Peter J., Chambless, Lola B., Zuckerman, Scott L.
Format: Article
Language:English
Subjects:
Cohort analysis
Cost-analysis
Cranioplasty
Epidural
GDP
Gross Domestic Product
Hospital costs
Humans
Infections
Length of stay
Neuroplasticity
Neurosurgery
Patients
Plastic surgery
Plastic Surgery Procedures
Postoperative Complications - epidemiology
Postoperative Complications - surgery
Retrospective Studies
Sepsis
Skull
Skull - surgery
Statistical analysis
Stroke
Surgeons
Surgery
Surgery, Plastic
Teams
Titanium
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container_title Clinical neurology and neurosurgery
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creator Dambrino, Robert J.
Liles, D. Campbell
Chen, Jeffrey W.
Chanbour, Hani
Koester, Stefan W.
Feldman, Michael J.
Chitale, Rohan V.
Morone, Peter J.
Chambless, Lola B.
Zuckerman, Scott L.
description Cranioplasty is a commonly performed neurosurgical procedure that restores cranial anatomy. While plastic surgeons are commonly involved with cranioplasties, the cost of performing a cranioplasty with neurosurgery alone (N) vs. neurosurgery and plastic surgery (N + P) is unknown. A single-center, multi-surgeon, retrospective cohort study was undertaken on all cranioplasties performed from 2012 to 22. The primary exposure variable of interest was operating team, comparing N vs. N + P. Cost data was inflation-adjusted to January 2022 using Healthcare Producer Price Index as calculated by the US Bureau of Labor Statistics. 186 patients (105 N vs. 81 N + P) underwent cranioplasties. The N + P group has a significantly longer length-of-stay (LOS) 4.5 ± 1.6days, vs. 6.0 ± 1.3days (p 
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Campbell ; Chen, Jeffrey W. ; Chanbour, Hani ; Koester, Stefan W. ; Feldman, Michael J. ; Chitale, Rohan V. ; Morone, Peter J. ; Chambless, Lola B. ; Zuckerman, Scott L.</creator><creatorcontrib>Dambrino, Robert J. ; Liles, D. Campbell ; Chen, Jeffrey W. ; Chanbour, Hani ; Koester, Stefan W. ; Feldman, Michael J. ; Chitale, Rohan V. ; Morone, Peter J. ; Chambless, Lola B. ; Zuckerman, Scott L.</creatorcontrib><description>Cranioplasty is a commonly performed neurosurgical procedure that restores cranial anatomy. While plastic surgeons are commonly involved with cranioplasties, the cost of performing a cranioplasty with neurosurgery alone (N) vs. neurosurgery and plastic surgery (N + P) is unknown. A single-center, multi-surgeon, retrospective cohort study was undertaken on all cranioplasties performed from 2012 to 22. The primary exposure variable of interest was operating team, comparing N vs. N + P. Cost data was inflation-adjusted to January 2022 using Healthcare Producer Price Index as calculated by the US Bureau of Labor Statistics. 186 patients (105 N vs. 81 N + P) underwent cranioplasties. The N + P group has a significantly longer length-of-stay (LOS) 4.5 ± 1.6days, vs. 6.0 ± 1.3days (p &lt; 0.001), but no significant difference in reoperation, readmission, sepsis, or wound breakdown. N was significantly less expensive than N + P during both the initial cranioplasty cost ($36,739 ± $4592 vs. $41,129 ± $4374, p 0.014) and total cranioplasty costs including reoperations ($38,849 ± $5017 vs. $53,134 ± $6912, p &lt; 0.001). Univariable analysis (threshold p = 0.20) was performed to justify inclusion into a multivariable regression model. Multivariable analysis for initial cranioplasty cost showed that sepsis (p = 0.024) and LOS (p = 0.003) were the dominant cost contributors compared to surgeon type (p = 0.200). 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All rights reserved.</rights><rights>2023. Elsevier B.V.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c396t-a060e41dbd7f04c0f8f428193a64ae69d9f043211fecefa43de89862d2702b733</citedby><cites>FETCH-LOGICAL-c396t-a060e41dbd7f04c0f8f428193a64ae69d9f043211fecefa43de89862d2702b733</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37030111$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dambrino, Robert J.</creatorcontrib><creatorcontrib>Liles, D. Campbell</creatorcontrib><creatorcontrib>Chen, Jeffrey W.</creatorcontrib><creatorcontrib>Chanbour, Hani</creatorcontrib><creatorcontrib>Koester, Stefan W.</creatorcontrib><creatorcontrib>Feldman, Michael J.</creatorcontrib><creatorcontrib>Chitale, Rohan V.</creatorcontrib><creatorcontrib>Morone, Peter J.</creatorcontrib><creatorcontrib>Chambless, Lola B.</creatorcontrib><creatorcontrib>Zuckerman, Scott L.</creatorcontrib><title>The cost of a plastic surgery team assisting with cranioplasty</title><title>Clinical neurology and neurosurgery</title><addtitle>Clin Neurol Neurosurg</addtitle><description>Cranioplasty is a commonly performed neurosurgical procedure that restores cranial anatomy. While plastic surgeons are commonly involved with cranioplasties, the cost of performing a cranioplasty with neurosurgery alone (N) vs. neurosurgery and plastic surgery (N + P) is unknown. 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A single-center, multi-surgeon, retrospective cohort study was undertaken on all cranioplasties performed from 2012 to 22. The primary exposure variable of interest was operating team, comparing N vs. N + P. Cost data was inflation-adjusted to January 2022 using Healthcare Producer Price Index as calculated by the US Bureau of Labor Statistics. 186 patients (105 N vs. 81 N + P) underwent cranioplasties. The N + P group has a significantly longer length-of-stay (LOS) 4.5 ± 1.6days, vs. 6.0 ± 1.3days (p &lt; 0.001), but no significant difference in reoperation, readmission, sepsis, or wound breakdown. N was significantly less expensive than N + P during both the initial cranioplasty cost ($36,739 ± $4592 vs. $41,129 ± $4374, p 0.014) and total cranioplasty costs including reoperations ($38,849 ± $5017 vs. $53,134 ± $6912, p &lt; 0.001). Univariable analysis (threshold p = 0.20) was performed to justify inclusion into a multivariable regression model. Multivariable analysis for initial cranioplasty cost showed that sepsis (p = 0.024) and LOS (p = 0.003) were the dominant cost contributors compared to surgeon type (p = 0.200). However, surgeon type (N vs. N + P) was the only significant factor (p = 0.011) for total cost including revisions. Higher costs to N + P involvement without obvious change in outcomes were found in patients undergoing cranioplasty. Although other factors are more significant for the initial cranioplasty cost (sepsis, LOS), surgeon type proved the independent dominant factor for total cranioplasty costs, including revisions. •We assessed the cost differences between neurosurgery (N) vs. neurosurgery and plastic surgery (N + P) in cranioplasty.•N + P showed a significant increase in length of stay with no apparent increase in complication rate or reoperation.•N was significantly less expensive than N + P during both the initial total cranioplasty costs including reoperations.•N + P was the independent factor increasing the total cranioplasty costs, including revisions.•The discrepancy in cost should be considered by neurosurgeons and plastic surgeons when determining appropriate care.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>37030111</pmid><doi>10.1016/j.clineuro.2023.107711</doi><tpages>1</tpages></addata></record>
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subjects Cohort analysis
Cost-analysis
Cranioplasty
Epidural
GDP
Gross Domestic Product
Hospital costs
Humans
Infections
Length of stay
Neuroplasticity
Neurosurgery
Patients
Plastic surgery
Plastic Surgery Procedures
Postoperative Complications - epidemiology
Postoperative Complications - surgery
Retrospective Studies
Sepsis
Skull
Skull - surgery
Statistical analysis
Stroke
Surgeons
Surgery
Surgery, Plastic
Teams
Titanium
title The cost of a plastic surgery team assisting with cranioplasty
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