Factors Associated with 30-Day Readmission after Endoscopic Transsphenoidal Surgery: The Critical Role of Dedicated Endocrinology Discharge Coordination

Abstract

Objectives

This study aimed to identify demographic, clinical, and operative factors of unplanned 30-day readmission following endoscopic transsphenoidal surgery (ETS).

Design

Single-center retrospective study.

Setting

A tertiary academic medical center based in New York, NY.

Participants

A total of 386 adult patients who underwent non-emergent ETS for pituitary adenomas between March 2009 and May 2020.

Main Outcome Measures

The primary outcome was 30-day unplanned hospital admission. Clinical and demographic characteristics were analyzed using χ² and Student's t-tests. For factors with p-value <0.1, multivariate logistic regression models were constructed to estimate the adjusted odds of 30-day readmission across predictive factors.

Results

Of 386 patients who received ETS, 29 (7.5%) patients required readmission within 30 days of discharge. Eleven (2.8%) patients were readmitted for complications related to electrolyte derangements (syndrome of inappropriate antidiuretic hormone, hyponatremia), followed by 5 (1.3%) patients with epistaxis. On multivariate analysis, pituitary microadenomas (p = 0.032), transient diabetes insipidus (DI; p = 0.021), and preoperative visual cranial nerve palsies (CN III/IV/VI; p = 0.019) were associated with increased odds of 30-day readmission.

Conclusion

Patients with pituitary microadenomas, transient DI, and preoperative cranial nerve palsies were at an increased risk for unplanned 30-day readmission after ETS. Dedicated neuroendocrinology involvement is necessary in the postoperative period to reduce readmission risk in these patients. Identification and careful monitoring of these at-risk populations is necessary, as targeted postdischarge care may prevent readmission and improve both patient and hospital outcomes.

Keywords

endoscopic transsphenoidal surgery - health care quality assurance - patient readmission - pituitary adenomas

Note

This abstract was accepted as a poster presentation at the North American Skull Base Society 2025 Annual Meeting on February 13–16, 2025, New Orleans, LA.

^‡ These authors contributed equally to this article.

Publication History

Received: 01 May 2025

Accepted: 05 October 2025

Accepted Manuscript online:
07 October 2025

Article published online:
17 October 2025

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