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March 4, 2026Stereotactic and Functional Neurosurgery0 citations

Impact of Hospital Volume Status on Postoperative Outcomes and Cost following Deep Brain Stimulation for Movement Disorders

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SPStefan T. PrvulovicOSOmar SbaihMCMichael M. Covell

Key Points

  • This study examines how the volume of surgeries performed by hospitals impacts postoperative outcomes and costs following deep brain stimulation for movement disorders.
  • Conducted a retrospective analysis of 6,964 DBS procedures from 234 US hospitals.
  • Categorized hospitals by DBS volume: high (≥450), medium (50-449), low (<50).
  • Utilized multivariable regression to assess outcomes including prolonged length of stay, non-routine discharge, and costs.
  • High-volume centers showed better outcomes with lower rates of prolonged length of stay (4.1% vs 8.9%, p<0.001).
  • Patients with Parkinson's disease had higher odds of prolonged stay but lower odds of non-routine discharge compared to those with essential tremor.
  • Dystonia patients had significantly higher odds of prolonged stay and incurring higher charges compared to other categories.

Abstract

Background and Objectives Deep brain stimulation (DBS) has emerged as a transformative neurosurgical intervention for refractory movement disorders, including Parkinson's disease (PD), essential tremor (ET), and dystonia. While clinical efficacy is well-established, significant variability exists in procedural outcomes across hospitals. This nationwide study investigated the impact of hospital procedural volume on short-term postoperative outcomes and cost following DBS across 234 US hospitals from 2015–2020. Methods We conducted a retrospective analysis of 6,964 DBS procedures (2015–2020) using the Nationwide Inpatient Sample. Hospitals were categorized by six-year DBS volume: high-volume centers (HVCs, ≥450), medium-volume (50–449), and low-volume (75th percentile), non-routine discharge (NRD), high charge (>90th percentile), and complications, controlling for patient demographics, comorbidities, and hospital characteristics. Results HVCs showed superior outcomes compared with low-volume centers, with lower rates of pLOS (4.1% vs 8.9%, p30% across centers. The volume–outcome relationship persists, with HVCs showing better efficiency but challenges in discharge disposition, highlighting the need for standardized care pathways for dystonia and closer evaluation of socioeconomic barriers to DBS access and outcomes.

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Cite This Study

Prvulovic et al. (2026) studied this question.

synapsesocial.com/papers/69a7ccd5d48f933b5eed8b0dhttps://doi.org/10.1159/000551148
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