Key result
Internal medicine-neurosurgical comanagement linked to ~48% fewer in-hospital medical complications versus traditional management.
Why the study?
The rising prevalence of chronic diseases has increased patient complexity, driving a need for organizational models combining surgical and medical disciplines within the same department.
Does internal medicine-neurosurgical comanagement reduce medical complications, ICU transfers, and readmissions in neurosurgical patients?
Cohort (n=747)
No
Does internal medicine-neurosurgical comanagement reduce medical complications, ICU transfers, and readmissions in neurosurgical patients?
Implementation of an internal medicine-neurosurgical comanagement program significantly reduced medical complications and ICU transfers, demonstrating the value of multidisciplinary care in complex surgical patients.
Answers are grounded in this paper and cite their sources.
Supports comanagement models in neurosurgery; leaves open confirmation of benefits in randomized trials.
The rising prevalence of chronic diseases have contributed to a population with high complexity of care. There has been an increasing need for a new organizational model based on the interaction in the same department between the specialist skills of surgical and medical disciplines. This study aims to describe the implementation of a hospitalist co-management program in a Neurosurgery Department (ND) and its impact on the incidence of medical complications, 30 days readmission rate for medical causes, number of transfers to Intensive Care Units (ICU)/Neurosurgical Intensive Care Unit (NICU) or to medical wards (MW), length-of stay (LOS), mortality and satisfaction of health workers. We conducted an observational study comparing changes before and after the Internal medicine-Neurosurgical Comanagement (INC) intervention. We conducted a retrospective evaluation of patients enrolled before the INC intervention and a prospective evaluation of those enrolled after the INC intervention was implemented. We defined the pre-INC intervention group as 380 patients admitted to the ND for neurosurgical disease between January 2022 and April 2022 and the post-INC intervention group as 367 patients admitted to the ND between January 2023 and April 2023. INC intervention was associated with a significant decrease in medical complications during the hospital stay (OR 0.52; 95% CI; 0.39-0.70, p < 0.001), 30 days in-hospital readmission for medical reasons (OR 0.95; 95% CI 0.93-0.97, p < 0.001) and numbers of transfers to ICU/NICU (OR 0.31; 95% CI; 0.17-0.55, p < 0.001) or MW (OR 0.51; 95% CI 0.33-0.77, p = 0.002). During the INC intervention period, we observed a high satisfaction rate in health workers, evaluated by standardized questionnaire. In our study, LOS, in-hospital mortality and 30-day mortality were not significantly associated with INC. Hospitalist co-management in Neurosurgical Departments was associated with a reduced incidence of medical complications, 30-days in-hospital readmission and numbers of transfers to ICU/NICU or MW with a high satisfaction rate among healthcare workers, but without a significant decrease in LOS and mortality rate.
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Para et al. (2025) conducted a cohort in Neurosurgical disease (n=747). Internal medicine-Neurosurgical Comanagement (INC) vs. Traditional management was evaluated on Medical complications during hospital stay (OR 0.52, 95% CI 0.39-0.70, p=<0.001). Internal medicine-neurosurgical comanagement significantly reduced the incidence of medical complications during hospital stay (OR 0.52) compared to traditional management.
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