Indication-Based Analysis of Patient Outcomes Following Neurostimulation. (16th November 2020)

• Record Type: Journal Article
• Authors: Tafreshi, Ali R; Shahrestani, Shane; Lien, Brian V; Ransom, Seth C; Brown, Nolan J; Lehrich, Brandon M; Ransom, Ryan C; Ballatori, Alexander; Ton, Andy; Chen, Xiao; Sahyouni, Ronald; Hanst, Brian
• Is Part Of: Neurosurgery. Volume 67(2010)Supplement 1
• Publication Date: 2020-11-16
• Subjects: Nervous system -- Surgery -- Periodicals; 617.48005
• DOI: 10.1093/neuros/nyaa447_653
• Languages: English
• ISSNs: 0148-396X

Abstract

Abstract: INTRODUCTION: While considered a safe operation, deep brain stimulation (DBS) has been associated with various morbidities. We assessed differences in postsurgical complication rates in patients undergoing the most common types of neurostimulation surgery. METHODS: The National Readmission Database (NRD) was queried to identify patients undergoing neurostimulation placement with the diagnosis of Parkinson disease (PD), epilepsy, dystonia, or essential tremor (ET). Demographics and complications, including infection, pneumonia, and neurostimulator revision, were queried for each cohort and compiled. Readmissions were assessed in 30-, 90-, and 180-day intervals. We implemented nearest-neighbour propensity score matching to control for demographic and sample size differences between groups. RESULTS: We identified 3, 230 patients with Parkinson disease, 1, 289 with essential tremor, 965 with epilepsy, and 221 with dystonia. Readmission rates 30-days after hospital discharge for PD patients (15.5%) were significantly greater than those for ET (7.8%) and seizure patients (4.4%). Pneumonia was reported for PD (1.6%), seizure (3.3%) and dystonia (1.7%) patients but not individuals ET. No PD patients were readmitted at 30-days due to dysphagia while individuals treated for ET (6.5%), seizure (1.6%) and dystonia (5.2%) were. DBS-revision surgery was performed for 11.48% of PD, 6.52% of ET, 1.64% of seizure and 6.90% of dystonia patients within 30-days of hospital discharge. CONCLUSION: 30-day readmission rates vary significantly between indications, with patients receiving DBS for PD having the highest rates. Further longitudinal studies are required to describe drivers of variation in postoperative outcomes following DBS surgery for different indications.