National 30-day readmission and prolonged length of stay after vestibular schwannoma surgery: Analysis of the Nationwide Readmissions Database.
Am J Otolaryngol
; 40(6): 102290, 2019.
Article
en En
| MEDLINE
| ID: mdl-31530434
ABSTRACT
PURPOSE:
To determine the risk factors for unanticipated readmission, prolonged index admission, and discharge to a facility after vestibular schwannoma surgery. MATERIALS ANDMETHODS:
Retrospective cohort study of those undergoing surgery for vestibular schwannoma in the Nationwide Readmissions Database (2013-2014). Main outcome measures included readmission rate, length of stay, discharge destination.RESULTS:
There were 4585 cases identified. The overall unanticipated readmission rate was 8.1%, and 9.1% had a prolonged length of stay (PLOS) of ≥7â¯days. Mean and median LOS were 4.63 and 4.00â¯days, respectively, and >90% of patients were discharged after 7â¯days. Disposition to a facility occurred in 6.7% of cases. Teaching hospitals were protective against unintended readmission (odds ratio [OR] 0.44, pâ¯<â¯.001). Major functional loss was associated with PLOS (OR 12.55, pâ¯<â¯.001). High volume centers were associated with decreased risk of PLOS (OR 0.46, pâ¯<â¯.001) and facility discharge (OR 0.68, pâ¯<â¯.001). The most common readmission diagnoses included "other nervous system complications" (nâ¯=â¯128), cerebrospinal fluid leak (nâ¯=â¯71), "other postoperative infection" (nâ¯=â¯61), and meningitis (nâ¯=â¯59).CONCLUSIONS:
Unanticipated readmission and prolonged LOS following vestibular schwannoma surgery are common, with varied sociodemographic, hospital, and patient factors independently associated with each. Further studies are needed to investigate targeted interventions aimed at minimizing readmission and prolonged LOS using the factors outlined above.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Readmisión del Paciente
/
Neuroma Acústico
/
Tiempo de Internación
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Am J Otolaryngol
Año:
2019
Tipo del documento:
Article