Thirty-Day Readmission Rates Following Deep Brain Stimulation Surgery

Ashwin G. Ramayya, Kalil G. Abdullah, Arka N. Mallela, John T. Pierce, Jayesh Thawani, Dmitry Petrov, Gordon H. Baltuch

Research output: Contribution to journalArticle

6 Citations (Scopus)

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 (Ps >.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).

Original languageEnglish (US)
Pages (from-to)259-267
Number of pages9
JournalNeurosurgery
Volume81
Issue number2
DOIs
StatePublished - Aug 1 2017
Externally publishedYes

Fingerprint

Deep Brain Stimulation
Hematoma
Infection
Comorbidity
Seizures
Neurosurgical Procedures
Patient Readmission
Movement Disorders
Malnutrition
Wound Healing
Medical Records
Inpatients
Electrodes
Cohort Studies
Retrospective Studies

Keywords

  • 30-day readmissions
  • Deep brain stimulation
  • Movement disorders
  • Parkinson's disease

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Ramayya, A. G., Abdullah, K. G., Mallela, A. N., Pierce, J. T., Thawani, J., Petrov, D., & Baltuch, G. H. (2017). Thirty-Day Readmission Rates Following Deep Brain Stimulation Surgery. Neurosurgery, 81(2), 259-267. https://doi.org/10.1093/neuros/nyx019

Thirty-Day Readmission Rates Following Deep Brain Stimulation Surgery. / Ramayya, Ashwin G.; Abdullah, Kalil G.; Mallela, Arka N.; Pierce, John T.; Thawani, Jayesh; Petrov, Dmitry; Baltuch, Gordon H.

In: Neurosurgery, Vol. 81, No. 2, 01.08.2017, p. 259-267.

Research output: Contribution to journalArticle

Ramayya, AG, Abdullah, KG, Mallela, AN, Pierce, JT, Thawani, J, Petrov, D & Baltuch, GH 2017, 'Thirty-Day Readmission Rates Following Deep Brain Stimulation Surgery', Neurosurgery, vol. 81, no. 2, pp. 259-267. https://doi.org/10.1093/neuros/nyx019
Ramayya AG, Abdullah KG, Mallela AN, Pierce JT, Thawani J, Petrov D et al. Thirty-Day Readmission Rates Following Deep Brain Stimulation Surgery. Neurosurgery. 2017 Aug 1;81(2):259-267. https://doi.org/10.1093/neuros/nyx019
Ramayya, Ashwin G. ; Abdullah, Kalil G. ; Mallela, Arka N. ; Pierce, John T. ; Thawani, Jayesh ; Petrov, Dmitry ; Baltuch, Gordon H. / Thirty-Day Readmission Rates Following Deep Brain Stimulation Surgery. In: Neurosurgery. 2017 ; Vol. 81, No. 2. pp. 259-267.
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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 (Ps >.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).",
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N2 - 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 (Ps >.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).

AB - 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 (Ps >.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).

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