title: A systematic review of 30-day readmission after cranial neurosurgery.
abstract: OBJECTIVE The 30-day readmission rate has emerged as an important marker of the quality of in-hospital care in several fields of medicine. This review aims to summarize available research reporting readmission rates after cranial procedures and to establish an association with demographic, clinical, and system-related factors and clinical outcomes. METHODS The authors conducted a systematic review of several databases; a manual search of the Journal of Neurosurgery, Neurosurgery, Acta Neurochirurgica, Canadian Journal of Neurological Sciences; and the cited references of the selected articles. Quality review was performed using the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) criteria. Findings are reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. RESULTS A total of 1344 articles published between 1947 and 2015 were identified; 25 were considered potentially eligible, of which 12 met inclusion criteria. The 30-day readmission rates varied from 6.9% to 23.89%. Complications arising during or after neurosurgical procedures were a prime reason for readmission. Race, comorbidities, and longer hospital stay put patients at risk for readmission. CONCLUSIONS Although readmission may be an important indicator for good care for the subset of acutely declining patients, neurosurgery should aim to reduce 30-day readmission rates with improved quality of care through systemic changes in the care of neurosurgical patients that promote preventive measures.
authors: Division of Neurosurgery, Keenan Research Centre and Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto.|Dalla Lana School of Public Health and Department of Surgery, University of Toronto, Ontario; and.
authors: Michael D
authors: MD
authors: Cusimano
authors: Division of Neurosurgery, Keenan Research Centre and Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto.
authors: Iryna
authors: I
authors: Pshonyak
authors: Division of Neurosurgery, Keenan Research Centre and Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto.
authors: Michael Y
authors: MY
authors: Lee
authors: Department of Community Health and Epidemiology, Department of Urology, Faculty of Medicine, Dalhousie University, Halifax, Canada.
authors: Gabriela
authors: G
authors: Ilie
mesh_terms: D001927:Brain Diseases / Q000601:surgery*; D006801:Humans; D019635:Neurosurgical Procedures; D010359:Patient Readmission / Q000706:statistics & numerical data*; D013997:Time Factors
keywords: CPT = current procedural terminology; DVT = deep venous thrombosis; LOS = length of stay; PE = pulmonary embolism; PRISMA = Preferred Reporting Items for Systematic Reviews and Meta-Analyses; STROBE = Strengthening the Reporting of Observational Studies in Epidemiology; VTE = venous thromboembolism; causes; cranial neurosurgery; outcomes; readmission; systematic review