Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
October 19, 2026 · via Europe PMC
Safety-Net Hospitals Have Increased Costs of Care Following Acoustic Neuroma Surgery.
Niksic A, Lipps D, Sakano H, Killeen D, Kutz JW, Isaacson B, Fujiwara RJT.
AI summary — for doctors, generated from the abstract only
Acoustic neuroma resection at safety-net hospitals carries more medical complications and higher hospitalization costs than at other hospitals.
What was studied
Retrospective analysis of 50,991 US adult admissions for acoustic neuroma resection (2001-2021) in the National Inpatient Sample, comparing safety-net with other hospitals.
Key findings
- About a quarter of admissions were at safety-net hospitals, which treated more Medicaid and lower-income patients.
- After adjustment, safety-net care was tied to higher odds of medical complications (OR 1.30) but not surgical/CNS complications.
- Mean costs were higher at safety-net hospitals ($42,749 vs $36,456), with an adjusted excess of about $35,679 per admission.
Clinical relevance
Neurotologic surgeons should recognize that hospital resource context and patient socioeconomic vulnerability shape postoperative medical risk and cost after skull base surgery.
Who should care
Limitations
Administrative database data lack granular clinical detail such as tumor size and facial nerve outcomes, and cannot establish causation.
Anticipate and plan for medical comorbidity and perioperative support in socioeconomically vulnerable acoustic neuroma patients, and support resourcing of safety-net centers.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Objective
To evaluate whether safety-net hospital (SNH) status is associated with differences in patient characteristics, postoperative complications, and hospitalization costs following acoustic neuroma resection.
Study design
Retrospective analysis of a nationally representative inpatient database.
Setting
United States acute care hospitals participating in the Healthcare Cost and Utilization Project National Inpatient Sample (NIS).
Patients
Adults (18 y or older) undergoing surgical excision of an acoustic neuroma from 2001 to 2021, identified using ICD-9-CM 04.01 and ICD-10-PCS 00BN0ZZ. Patients with neurofibromatosis type 2 were excluded.
Interventions
Craniotomy for excision of acoustic neuroma.
Main outcome measures
Postoperative surgical/CNS and medical complications; total inpatient hospitalization costs.
Results
The cohort included 50,991 admissions, of which 13,245 (26.0%) occurred at SNHs. SNH patients were more likely to have Medicaid insurance (8.9% vs. 4.2%) and lower household income. On univariate analysis, SNHs had higher rates of hydrocephalus (6.0% vs. 3.8%), dysphagia (4.3% vs. 2.2%), pulmonary edema (2.1% vs. 1.1%), and sepsis (0.9% vs. 0.2%). After multivariable adjustment, SNH care remained independently associated with increased odds of medical complications (OR: 1.30; 95% CI: 1.01-1.70; P=0.04) but not surgical/CNS complications (OR: 1.10; P=0.23). Mean hospitalization costs were higher in SNHs ($42,749 vs. $36,456; P=0.003), and SNH status independently increased costs by $35,679 per admission (P=0.02).
Conclusions
SNHs care for socioeconomically vulnerable patients undergoing acoustic neuroma resection and experience higher medical complication rates and significantly increased hospitalization costs. These findings highlight the need for resource-informed policy efforts and targeted support to sustain equitable access to complex neurotologic surgery.
Level of evidence
Level III.
DOI
10.1097/mao.0000000000005101
PMID
42895989
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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