Cohort study of role of hospital connectedness in brain metastasis outcomes

Patients with brain metastases usually receive interdisciplinary and multi-institutional care. A cohort study in Massachusetts investigated the association of hospital connectedness with outcomes of patients with brain metastases. In this cohort study of 4679 patients with brain metastases, increased connectedness of a hospital (defined as the weighted sum of ties to other hospitals) was associated with improved inpatient mortality (lowest connectedness quartile versus highest quartile: OR 2.34; p=0.003). Highly connected hospitals werd heterogeneous, with many being small and one-half lacking subspecialty neuro-oncologic care. Hospital connectedness operated independently from hospital volume in its assocation with inpatient mortality and length of stay. The authors conclude that these findings suggest that relationships between hospitals are associated with changes in patient outcomes in the interdisciplinary care of patients with brain metastases, likely owing to the specialized and interdisciplinary care required in the disease management.