Predictors of readmission after craniotomy for meningioma resection: a nationwide readmission database analysis.

Abstract

BACKGROUND:

Meningiomas are the most common benign primary brain tumors. The mainstay of treatment, surgical resection, is often curative. Given the excellent prognosis of these lesions, minimizing perioperative complications is of the utmost importance. With the establishment of the National Readmissions Database (NRD), researchers are now able to identify variables associated with postoperative complications beyond the index admission.

OBJECTIVE:

In this study, we sought to identify the leading causes for non-elective readmission and variables associated with increased likelihood of readmission at 30 and 90 days after discharge following a craniotomy for meningioma resection.

METHODS:

Adult inpatients who underwent craniotomy for meningioma resection between 2010 and 2014 were queried from the NRD. All-cause readmissions following craniotomy at 30 and 90 days were identified, and a multivariable logistic regression model was used to characterize independent risk factors.

RESULTS:

Among 26,034 patients who received craniotomy for meningioma resection, 2825 (10.9%) were readmitted at 30 days and 3436 (16.1%) were readmitted at 90 days. Postoperative wound infection was the most common readmission diagnosis, occurring in 9.32% and 10.2% of 30- and 90-day readmissions respectively. Patient factors associated with increased likelihood of readmission included male gender, greater illness severity, non-routine discharge, index length of hospitalization, and having Medicare or Medicaid insurance.

CONCLUSIONS:

Readmission following craniotomy for meningioma resection occurs at a clinically significant rate. Several patient factors were identified in association with all-cause 30- and 90-day readmissions. Further studies are required to identify means for preventing complications following discharge in these vulnerable patient populations.

• Authors: Michelle Lin, Elliot Min, Elliott A Orloff, Li Ding, Kerolos S R Youssef, James S Hu, Steven L Giannotta, William J Mack, Frank J Attenello
• Journal: Acta neurochirurgica (Acta Neurochir (Wien)) Vol. 162 Issue 11 Pg. 2637-2646 (11 2020) ISSN: 0942-0940 [Electronic] Austria
• PMID: 32779026 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Craniotomy (adverse effects)
• Databases, Factual
• Female
• Humans
• Male
• Medicare
• Meningeal Neoplasms (surgery)
• Meningioma (surgery)
• Middle Aged
• Patient Discharge
• Patient Readmission
• Risk Factors
• Sex Factors
• Surgical Wound Infection (etiology)
• United States
• Young Adult