title: Increased Operative Time for Benign Cranial Nerve Tumor Resection Correlates with Increased Morbidity Postoperatively.
abstract: OBJECTIVE
  Operative time, previously identified as a risk factor for postoperative morbidity, is examined in patients undergoing benign cranial nerve tumor resection.
  
  
  METHODS
  This retrospective cohort analysis included patients enrolled in the ACS-NSQIP registry from 2007 through 2013 with a diagnosis of a benign cranial nerve neoplasm.
  
  
  METHODS
  Primary outcomes included postoperative morbidity and mortality. Readmission and reoperation served as secondary outcomes.
  
  
  RESULTS
  A total of 565 patients were identified. Mean (median) operative time was 398 (370) minutes. The 30-day complication, readmission, and return to the operating room rates were 9.9%, 9.9%, and 7.3%, respectively, on unadjusted analyses. CSF leak requiring reoperation or readmission occurred at a rate of 3.1%. On multivariable regression analysis, operations greater than 413 minutes were associated with an increased odds of overall complication (OR 4.26, 95% CI 2.08-8.72), return to the operating room (OR 2.65, 95% CI 1.23-5.67), and increased length of stay(1.6 days, 95% CI 0.94-2.23 days). Each additional minute of operative time was associated with an increased odds of overall complication (OR 1.004, 95% CI 1.002-1.006) and increased length of stay (0.006 days, 95% CI 0.004-0.008).
  
  
  CONCLUSIONS
  Increased operative time in patients undergoing surgical resection of a benign cranial nerve neoplasm was associated with an increased rate of complications.
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, United States.
authors.forename: Meghan
authors.initials: M
authors.lastname: Murphy
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, United States.
authors.forename: Hannah
authors.initials: H
authors.lastname: Gilder
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, United States.
authors.forename: Brandon A
authors.initials: BA
authors.lastname: McCutcheon
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, United States.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Kerezoudis
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, United States.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Rinaldo
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, United States.
authors.forename: Daniel
authors.initials: D
authors.lastname: Shepherd
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, United States.
authors.forename: Patrick
authors.initials: P
authors.lastname: Maloney
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, United States.
authors.forename: Kendall
authors.initials: K
authors.lastname: Snyder
authors.affiliation: Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota, United States.
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Carlson
authors.affiliation: Department of Neurologic Surgery University of California, San Diego, United States.
authors.forename: Bob S
authors.initials: BS
authors.lastname: Carter
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, United States.
authors.forename: Mohamad
authors.initials: M
authors.lastname: Bydon
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, United States.
authors.forename: Jamie J
authors.initials: JJ
authors.lastname: Van Gompel
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, United States.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Link
keywords: acoustic neuroma; complications; national surgical quality improvement program; operative time; skull base; vestibular schwannoma