Thirty-day readmission risk after intracranial tumor resection surgeries in children

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OBJECTIVE

The risk of readmission after brain tumor resection among pediatric patients has not been defined. The authors’ objective was to evaluate the readmission rates and predictors of readmission after pediatric brain tumor resection.

METHODS

Nationwide Readmissions Database (NRD) data sets from 2010 to 2014 were searched for unplanned readmissions within 30 days of the discharge date after pediatric brain tumor resection. Patient demographic variables included sex, age, expected payment source (Medicaid or private insurance), and median annual household income. Readmission events for chemotherapy, radiation therapy, or further tumor resection were not included.

RESULTS

Of 282 patients (12.7%) readmitted within 30 days of the index event, the median time to readmission was 10 days (IQR 5–19 days). The most common reason for readmission was hydrocephalus, which accounted for 19% of readmission events. Other CNS-related complications (24%), surgical site infections or septicemia (14%), seizures (7%), and hematological disorders (7%) accounted for other major readmission events. The median charge for readmission events was $35,431, and the median length of readmission stay was 4 days. In multivariate regression, factors associated with a significant increase in readmission risk included Medicaid as the primary payor, discharge from the index event with home health services, and fluid and electrolyte disorders during the index event.

CONCLUSIONS

More than 10% of pediatric brain tumor patients have unplanned readmission events within 30 days of discharge after tumor resection. Medicaid patients and those with preoperative or early postoperative fluid and electrolyte disturbances may benefit from early or frequent outpatient visits after tumor resection.

ABBREVIATIONS DRG = Diagnosis Related Group; NRD = Nationwide Readmissions Database; VP = ventriculoperitoneal.
Article Information

Contributor Notes

Correspondence M. Burhan Janjua: UT Southwestern Medical Center, Dallas, TX. mburhanj@gmail.com.INCLUDE WHEN CITING Published online November 1, 2019; DOI: 10.3171/2019.7.PEDS19272.Disclosures Dr. Welch: stock ownership in Transcendental Spine. Dr. Samdani: consultant for DePuy Synthes Spine, Ethicon, Globus Medical, NuVasive, Stryker, and Zimmer Biomet; and royalties from NuVasive and Zimmer Biomet.
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