Reid A Johnson1, Truong H Do2, Elise F Palzer3, Samuel W Cramer2, Jacob T Hanson2, Jared D Huling3, Daniel G Hoody4, Abigail L Rice1, Amber N Piazza1, Madeleine A Howard1, Robert A McGovern2, Clark C Chen5. 1. University of Minnesota Medical School, Minneapolis, MN, USA. 2. Department of Neurological Surgery, University of Minnesota, 420 Delaware St SE, MMC 96, Room D-429, Minneapolis, MN, 55455, USA. 3. Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA. 4. Internal Medicine Department, Hennepin Healthcare, Minneapolis, MN, USA. 5. Department of Neurological Surgery, University of Minnesota, 420 Delaware St SE, MMC 96, Room D-429, Minneapolis, MN, 55455, USA. ccchen@umn.edu.
Abstract
PURPOSE: Understanding factors that influence technology diffusion is central to clinical translation of novel therapies. We characterized the pattern of adoption for laser interstitial thermal therapy (LITT), also known as stereotactic laser ablation (SLA), in neuro-oncology using the National Inpatient Sample (NIS) database. METHODS: We identified patients age ≥ 18 in the NIS (2012-2018) with a diagnosis of primary or metastatic brain tumor that underwent LITT or craniotomy. We compared characteristics and outcomes for patients that underwent these procedures. RESULTS: LITT utilization increased ~ 400% relative to craniotomy during the study period. Despite this increase, the total number of LITT procedures performed for brain tumor was < 1% of craniotomy. After adjusting for this time trend, LITT patients were less likely to have > 2 comorbidities (OR 0.64, CI95 0.51-0.79) or to be older (OR 0.92, CI95 0.86-0.99) and more likely to be female (OR 1.35, CI95 1.08-1.69), Caucasian compared to Black (OR 1.94, CI95 1.12-3.36), and covered by private insurance compared to Medicare or Medicaid (OR 1.38, CI95 1.09-1.74). LITT hospital stays were 50% shorter than craniotomy (IRR 0.52, CI95 0.45-0.61). However, charges related to the procedures were comparable between LITT and craniotomy ($1397 greater for LITT, CI95 $-5790 to $8584). CONCLUSION: For neuro-oncology indications, LITT utilization increased ~ 400% relative to craniotomy. Relative to craniotomy-treated patients, LITT-treated patients were likelier to be young, female, non-Black race, covered by private insurance, or with < 2 comorbidities. While the total hospital charges were comparable, LITT was associated with a shorter hospitalization relative to craniotomy.
PURPOSE: Understanding factors that influence technology diffusion is central to clinical translation of novel therapies. We characterized the pattern of adoption for laser interstitial thermal therapy (LITT), also known as stereotactic laser ablation (SLA), in neuro-oncology using the National Inpatient Sample (NIS) database. METHODS: We identified patients age ≥ 18 in the NIS (2012-2018) with a diagnosis of primary or metastatic brain tumor that underwent LITT or craniotomy. We compared characteristics and outcomes for patients that underwent these procedures. RESULTS: LITT utilization increased ~ 400% relative to craniotomy during the study period. Despite this increase, the total number of LITT procedures performed for brain tumor was < 1% of craniotomy. After adjusting for this time trend, LITT patients were less likely to have > 2 comorbidities (OR 0.64, CI95 0.51-0.79) or to be older (OR 0.92, CI95 0.86-0.99) and more likely to be female (OR 1.35, CI95 1.08-1.69), Caucasian compared to Black (OR 1.94, CI95 1.12-3.36), and covered by private insurance compared to Medicare or Medicaid (OR 1.38, CI95 1.09-1.74). LITT hospital stays were 50% shorter than craniotomy (IRR 0.52, CI95 0.45-0.61). However, charges related to the procedures were comparable between LITT and craniotomy ($1397 greater for LITT, CI95 $-5790 to $8584). CONCLUSION: For neuro-oncology indications, LITT utilization increased ~ 400% relative to craniotomy. Relative to craniotomy-treated patients, LITT-treated patients were likelier to be young, female, non-Black race, covered by private insurance, or with < 2 comorbidities. While the total hospital charges were comparable, LITT was associated with a shorter hospitalization relative to craniotomy.
Authors: Robert C Rennert; Usman Khan; Jiri Bartek; Stephen B Tatter; Melvin Field; Brian Toyota; Peter E Fecci; Kevin Judy; Alireza M Mohammadi; Patrick Landazuri; Andrew E Sloan; Albert H Kim; Eric C Leuthardt; Clark C Chen Journal: Neurosurgery Date: 2020-04-01 Impact factor: 4.654
Authors: Truong H Do; Madeleine A Howard; Elise F Palzer; Jared D Huling; Mohammed A Alvi; Samuel W Cramer; Ping Zhu; Reid A Johnson; James Jean; Jinci Lu; Alec B Jonason; Jacob Hanson; Luke Sabal; Kevin W Sun; Robert A McGovern; Clark C Chen Journal: J Neurooncol Date: 2022-07-23 Impact factor: 4.506
Authors: Samuel W Cramer; Truong H Do; Elise F Palzer; Anant Naik; Abigail L Rice; Savannah G Novy; Jacob T Hanson; Amber N Piazza; Madeleine A Howard; Jared D Huling; Clark C Chen; Robert A McGovern Journal: Ann Neurol Date: 2022-05-10 Impact factor: 11.274