Thirty-Day Readmission Rates Following Deep Brain Stimulation Surgery. Issue 2 (15th March 2017)

• Record Type: Journal Article
• Authors: Ramayya, Ashwin G.; Abdullah, Kalil G.; Mallela, Arka N.; Pierce, John T.; Thawani, Jayesh; Petrov, Dmitry; Baltuch, Gordon H.
• Is Part Of: Neurosurgery. Volume 81:Issue 2(2017)
• Page Start: 259
• Page End: 267
• Publication Date: 2017-03-15
• Subjects: Deep brain stimulation -- 30-day readmissions -- Parkinson's disease -- Movement disorders; Nervous system -- Surgery -- Periodicals; 617.48005
• DOI: 10.1093/neuros/nyx019
• Languages: English
• ISSNs: 0148-396X

Abstract

Abstract: BACKGROUND: Deep brain stimulation (DBS) has emerged as a safe and efficacious surgical intervention for several movement disorders; however, the 30-day all-cause readmission rate associated with this procedure has not previously been documented. OBJECT: To perform a retrospective cohort study to estimate the 30-day all-cause readmission rate associated with DBS. METHODS: We reviewed medical records of patients over the age of 18 who underwent DBS surgery at Pennsylvania Hospital of the University of Pennsylvania between 2009 and 2014. We identified patients who were readmitted to an inpatient medical facility within 30 days from their initial discharge. RESULTS: Over the study period, 23 (6.6%) of 347 DBS procedures resulted in a readmission to the hospital within 30 days. Causes of readmission were broadly categorized into surgery-related (3.7%): intracranial lead infection (0.6%), battery-site infection (0.6%), intracranial hematoma along the electrode tract (0.6%), battery-site hematoma (0.9%), and seizures (1.2%); and nonsurgery-related (2.9%): altered mental status (1.8%), nonsurgical-site infections (0.6%), malnutrition and poor wound healing (0.3%), and a pulse generator malfunction requiring reprogramming (0.3%). Readmissions could be predicted by the presence of medical comorbidities ( P < .001), but not by age, gender, or length of stay ( P s > .15). CONCLUSION: All-cause 30-day readmission for DBS is 6.6%. This compares favorably to previously studied neurosurgical procedures. Readmissions frequently resulted from surgery-related complications, particularly infection, seizures, and hematomas, and were significantly associated with the presence of medical comorbidities ( P < .001).