Does Hospital Volume Affect Outcomes in Patients Undergoing Vestibular Schwannoma Surgery?

Objective: To determine the effect of hospital surgical case volume on the outcomes of vestibular schwannoma surgery. Study Design: Retrospective case review. Setting: University HealthSystem Consortium member hospitals (includes nearly every US academic medical center). Patients: Three thousand six hundred ninety-seven patients who underwent vestibular schwannoma resection over a 3-year timespan (2012–2015) grouped by race, age, comorbidities, payer, and sex. Intervention: Surgical resection of vestibular schwannoma. Main Outcome Measures: Morbidity and mortality following vestibular schwannoma excision are compared by hospital volume (low, medium, and high) including deciles. Results: There was significantly longer length of stay (p ≤ 0.005) among groups with low-volume hospitals followed by medium-volume hospitals and high-volume hospitals. Low-volume hospitals had a significantly higher rate of complications including stroke, aspiration, and respiratory failure (p ≤ 0.0175). Patient characteristics of age, sex, sex, and baseline comorbidities were similar between hospital groups. However, patients at high-volume hospitals were more likely to be Caucasian (83.1%, p = 0.0001) and have private insurance (76.7%, p 

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