title: Descriptive analysis of unplanned readmission and reoperation rates after intradural spinal tumor resection.
abstract: BACKGROUND
  Spinal cord tumors (SCT) are relatively uncommon and usually require surgical treatment. Readmission within 30days after discharge is an important indicator of health care quality. The aim of this study was to investigate the rates and causes of unplanned readmissions and reoperations after SCT surgery.
  
  
  METHODS
  A retrospective analysis of patients' charts at a single center from May 2007 to September 2015 was completed.
  
  
  METHODS
  history of laminectomy with excision of neoplasm in the spinal cord.
  
  
  METHODS
  (1) surgery outside the timeframe; (2) less than 19years old; (3) non-neoplastic intramural pathologies; (4) previous resection at the same location; (5) metastatic lesions.
  
  
  RESULTS
  We found 131 patients that met criteria. Six patients (4.5%) were readmitted within 30days and two within 90days (1.5%). Four underwent reoperation: one for a cerebrospinal fluid leak, two for pseudomenigoceles, and one for repeat laminectomy. Resection of intramedullary tumors resulted in twice the risk of having one or more complications compared to extramedullary tumors (RR 2.0; 95% CI: 1.0-4.2; p=0.057), and nearly four times the risk of having a neurological complication (RR 3.8; 95% CI 1.5-9.5; p=0.005).
  
  
  CONCLUSIONS
  This study analyzes readmission, reoperation and complication rates for the surgical care of SCT highlighting how SCT surgery is still involved with morbidity in experienced and specialized centers. This information is useful both for health care enhancement projects and for evidence-based patient counseling.
authors.affiliation: Swedish Neuroscience Institute, Swedish Medical Center, Seattle, WA, United States; Seattle Science Foundation, Seattle, WA, United States; Department of General and Trauma Surgery, BG University Hospital, Bergmannsheil Bochum, Germany. Electronic address: christian.fisahn@gmail.com.
authors.forename: Christian
authors.initials: C
authors.lastname: Fisahn
authors.affiliation: Seattle Science Foundation, Seattle, WA, United States.
authors.forename: Felipe H
authors.initials: FH
authors.lastname: Sanders
authors.affiliation: Department of Neurosurgery, Wayne State University, Detroit, MI, United States.
authors.forename: Marc
authors.initials: M
authors.lastname: Moisi
authors.affiliation: Swedish Neuroscience Institute, Swedish Medical Center, Seattle, WA, United States.
authors.forename: Jeni
authors.initials: J
authors.lastname: Page
authors.affiliation: Seattle Science Foundation, Seattle, WA, United States.
authors.forename: Peter C
authors.initials: PC
authors.lastname: Oakes
authors.affiliation: Seattle Science Foundation, Seattle, WA, United States.
authors.forename: Mary
authors.initials: M
authors.lastname: Wingerson
authors.affiliation: Spectrum Research, Inc., Tacoma, WA, United States.
authors.forename: Joe
authors.initials: J
authors.lastname: Dettori
authors.affiliation: Seattle Science Foundation, Seattle, WA, United States.
authors.forename: R Shane
authors.initials: RS
authors.lastname: Tubbs
authors.affiliation: Department of Neurosurgery, Wayne State University, Detroit, MI, United States.
authors.forename: Parthasarathi
authors.initials: P
authors.lastname: Chamiraju
authors.affiliation: Swedish Neuroscience Institute, Swedish Medical Center, Seattle, WA, United States.
authors.forename: Peter
authors.initials: P
authors.lastname: Nora
authors.affiliation: Swedish Neuroscience Institute, Swedish Medical Center, Seattle, WA, United States.
authors.forename: David
authors.initials: D
authors.lastname: Newell
authors.affiliation: Swedish Neuroscience Institute, Swedish Medical Center, Seattle, WA, United States.
authors.forename: Johnny
authors.initials: J
authors.lastname: Delashaw
authors.affiliation: Swedish Neuroscience Institute, Swedish Medical Center, Seattle, WA, United States.
authors.forename: Rod J
authors.initials: RJ
authors.lastname: Oskouian
authors.affiliation: Swedish Neuroscience Institute, Swedish Medical Center, Seattle, WA, United States.
authors.forename: Jens R
authors.initials: JR
authors.lastname: Chapman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007796:Laminectomy / Q000009:adverse effects / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D012086:Reoperation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013120:Spinal Cord Neoplasms / Q000601:surgery*; D055815:Young Adult
keywords: Health care costs; Patient readmission; Postoperative complications; Reoperation; Spinal cord neoplasms