J Neurol Surg B Skull Base 2019; 80(S 01): S1-S244
DOI: 10.1055/s-0039-1679629
Oral Presentations
Georg Thieme Verlag KG Stuttgart · New York

Predicting Readmission and Reoperation for Vestibular Schwannoma: A Nationwide Analysis

Authors

  • Hassan Y. Dawood

    1   Computational Neuroscience Outcomes Center, Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States
  • Saksham Gupta

    1   Computational Neuroscience Outcomes Center, Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States
  • Abdul-Kareem Ahmed

    2   Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland, United States
  • Wenya L. Bi

    3   Center for Skull Base and Pituitary Surgery, Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States
  • Julian B. Iorgulescu

    4   Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States
  • Carleton E. Corrales

    5   Department of Otolaryngology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States
  • Ian F. Dunn

    3   Center for Skull Base and Pituitary Surgery, Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States
  • Timothy R. Smith

    1   Computational Neuroscience Outcomes Center, Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
06. Februar 2019 (online)

 

Objective: Readmission and reoperation are unfortunate risks in the resection of benign cranial nerve tumors (BCNTs). This report analyzes the impact of patient-level and surgical factors on these adverse outcomes.

Methods: A retrospective cohort review of patients diagnosed with a BCNT enrolled in the American College of Surgeons-National Surgical Quality Improvement Program registry from 2011 to 2015 was performed. Multivariable logistic regression was utilized to determine the impact of select medical and operative factors on the primary outcomes, readmission and reoperation within 30 days, adjusted for relevant covariates.

Results: A total of 996 patients who underwent resection of a BCNT were identified. The most frequent major complications were readmission (11%), reoperation (8%), surgical site infections (2.6%), and venous thromboembolism (1.5%). The most frequent indications for readmission included management of infection (2.5%), CSF leak (2.3%), and hydrocephalus (0.5%), among others. Repair of cranial and meningeal defects (3.0%), correction of lagophthalmos (1.2%), and repair of middle ear defects (1.0%) were the most common indications for reoperation. Logistic regression revealed that extremes of age were associated with readmission, while preoperative steroid usage, long operative time, and postoperative length of stay over 3 days were associated with reoperation (p < 0.05). Obesity trended toward an association with readmission and reoperation.

Conclusion: Extremes of age were associated with readmission; preoperative steroid use, long operative time, and postoperative length of stay greater than 3 days were associated with reoperation. Surgeons should consider these factors when assessing risk of postoperative complications for BCNTs.