Kamp Marcel A, Jungk Christine, Schneider Matthias, Fehler Georgia, Santacroce Antonio, Dinc N, Ebner Florian H, von Sass Christiane
Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, Neuruppin, Germany.
Department of Palliative and Neuropalliative Care, Immanuel Clinic Rüdersdorf, University Hospital of the Brandenburg Medical School Theodor Fontane, Rüdersdorf bei Berlin, Seebad 82/83, 15562, Rüdersdorf near Berlin, Germany.
Neurosurg Rev. 2025 Jun 23;48(1):525. doi: 10.1007/s10143-025-03664-1.
Neurosurgical conditions and procedures are associated with varying in-hospital mortality rates, which represent one of several quality indicators. This study aims to determine and report in-hospital mortality rates across German neurosurgical departments in 2023.
A cross-sectional analysis of all neurosurgical cases treated in Germany in 2023 was conducted using nationwide hospital billing data reported under § 21 of the Hospital Remuneration Act. In-hospital mortality was defined as death during hospitalization (discharge status: deceased).
Neurosurgical departments treated 222,158 inpatient cases, with 49% female and 48% aged ≥ 65 years. The overall mortality rate was 3.8% (8,338 cases), with significantly lower rates in females (3.3% vs. 4.2%, p < 0.0001). The most common fatal diagnoses included traumatic subdural hematomas (1,278 cases), subcortical intracerebral hemorrhages (611 cases) and traumatic subarachnoid hemorrhages (504 cases). Mortality rates varied by diagnosis: malignant brain tumors (4%), cerebral metastases (6%), benign meningeal tumors (1.3%), non-traumatic subarachnoid hemorrhages (7%), intracerebral hemorrhages (29%), and traumatic subdural hematomas (12%). Mortality for selected procedures was 3% for primary brain tumor resections, 9% for vascular reconstructions, 1% for spinal fusions, 2% for dynamic stabilizations, and 4% for vertebral body replacements.
This study analyzes and reports neurosurgical in-hospital mortality rates in Germany, providing a national benchmark that may inform clinicians, policymakers, and patients. While the use of administrative billing data imposes inherent limitations - particularly regarding clinical detail and causality - the findings may offer a foundation for future research. Subsequent studies should aim to explore disease- and procedure-specific mortality more granularly and may identify underlying risk factors.
Not applicable.
神经外科疾病及手术的院内死亡率各不相同，这是多项质量指标之一。本研究旨在确定并报告2023年德国各神经外科科室的院内死亡率。
利用《医院薪酬法》第21条规定上报的全国医院计费数据，对2023年德国治疗的所有神经外科病例进行横断面分析。院内死亡定义为住院期间死亡（出院状态：已死亡）。
神经外科科室共治疗了222,158例住院病例，其中49%为女性，48%年龄≥65岁。总体死亡率为3.8%（8338例），女性死亡率显著较低（3.3%对4.2%，p<0.0001）。最常见的致命诊断包括创伤性硬膜下血肿（1278例）、皮质下脑出血（611例）和创伤性蛛网膜下腔出血（504例）。死亡率因诊断而异：恶性脑肿瘤（4%）、脑转移瘤（6%）、良性脑膜瘤（1.3%）、非创伤性蛛网膜下腔出血（7%）、脑出血（29%）和创伤性硬膜下血肿（12%）。特定手术的死亡率为：原发性脑肿瘤切除术3%，血管重建术9%，脊柱融合术1%，动态稳定术2%，椎体置换术4%。
本研究分析并报告了德国神经外科的院内死亡率，提供了一个全国性基准，可为临床医生、政策制定者和患者提供参考。虽然使用行政计费数据存在固有局限性——尤其是在临床细节和因果关系方面——但研究结果可为未来研究提供基础。后续研究应更细致地探讨疾病和手术特定的死亡率，并可能识别潜在风险因素。
不适用。
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