Organization and resource utilization of specialized neurosurgical care for chiasmatic–sellar tumors in a metropolitan health system: a hospital-based study from Kazakhstan

Background/objectives: Chiasmatic-sellar region tumors represent a significant burden for specialized healthcare services due to the need for complex diagnostics, multidisciplinary management, and prolonged inpatient treatment. In the absence of population-based registries, hospital-based analyses provide important insights into the organization of care and resource utilization. This study aimed to assess the organization and key characteristics of specialized neurosurgical care for patients with chiasmatic-sellar tumors in a large metropolitan center in Kazakhstan. Methods: A retrospective hospital-based study was conducted using medical records of adult patients treated for chiasmatic-sellar region tumors in a tertiary neurosurgical center in Almaty between 2019 and 2024. Demographic characteristics, tumor structure, surgical activity dynamics, length of hospital stay, intensive care unit (ICU) utilization, perioperative complications, reoperations, and in-hospital mortality were analyzed using descriptive statistical methods. Results: A total of 342 patients were included (mean age 49.6 ± 14.2 years; 59.9% women). Pituitary adenomas accounted for 82.2% of cases. Surgical activity varied over time, with a temporary decline followed by a compensatory increase in subsequent years. Median length of hospital stay was 16 days (IQR 14-20), and routine short-term ICU monitoring was required for the majority of patients. Postoperative complications occurred in 5.8% of cases, reoperations in 4.1%, and in-hospital mortality was 2.6%. Conclusions: This hospital-based study highlights key organizational features and resource utilization patterns of specialized neurosurgical care for chiasmatic-sellar tumors in a metropolitan setting. These findings provide real-world evidence to support planning and optimization of centralized neurosurgical services in metropolitan health systems of middle-income countries, particularly with regard to inpatient capacity, intensive care utilization, and standardized postoperative pathways.