Thirty-Day Readmission Rates Following Deep Brain Stimulation Surgery.
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.


OBJECTIVE
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).


CONCLUSIONS
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).
Department of Neurosurgery, Perelman School of Medicine, University of Penn-sylvania, Philadelphia, Pennsylvania.
Ashwin G
AG
Ramayya
Department of Neurosurgery, Perelman School of Medicine, University of Penn-sylvania, Philadelphia, Pennsylvania.
Kalil G
KG
Abdullah
Department of Neurosurgery, Perelman School of Medicine, University of Penn-sylvania, Philadelphia, Pennsylvania.
Arka N
AN
Mallela
Department of Neurosurgery, Perelman School of Medicine, University of Penn-sylvania, Philadelphia, Pennsylvania.
John T
JT
Pierce
Department of Neurosurgery, Perelman School of Medicine, University of Penn-sylvania, Philadelphia, Pennsylvania.
Jayesh
J
Thawani
Department of Neurosurgery, Perelman School of Medicine, University of Penn-sylvania, Philadelphia, Pennsylvania.
Dmitry
D
Petrov
Department of Neurosurgery, Perelman School of Medicine, University of Penn-sylvania, Philadelphia, Pennsylvania.
Gordon H
GH
Baltuch
D000328:Adult; D046690:Deep Brain Stimulation / Q000009:adverse effects / Q000706:statistics & numerical data; D006801:Humans; D010359:Patient Readmission / Q000706:statistics & numerical data*; D010414:Pennsylvania / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology / Q000628:therapy; D012189:Retrospective Studies
30-day readmissions; Deep brain stimulation; Movement disorders; Parkinson's disease