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National Analysis of DBS Rates, Causes, and Outcomes

Clin Neurol Neurosurg; 2018 Aug; Rumalla, et al

All-cause, unplanned readmission for deep brain stimulation (DBS) was 1.9% within 30-days and 4.3% within 90-days, according to a recent study that sought to determine the national rates, causes, predictors, and outcomes associated with 30-day and 90-day readmission. The Nationwide Readmissions Database (NRD) was used to identify patients who underwent DBS for movement disorder (Parkinson disease [PD], essential tremor [ET], or dystonia). Variables included categorical age, gender, insurance, comorbidities, type of movement disorder, length of stay (LOS), total costs, and discharge disposition. Researchers found:

  • A total of 3,392 DBS patients were identified [PD (70.7%), ET (25.6%), dystonia (3.7%)].
  • The rate of unplanned readmissions was 1.9% at 30-days and 4.3% at 90 days.
  • The overall NRD incidence (all patient populations) of 30-day readmission is 11.6%.
  • Readmissions most frequently resulted from surgical complications including hematoma and attention to surgical wounds.
  • Elderly, obese, and those with comorbidities such as history of stroke or coronary artery disease are at highest risk.
  • The average LOS, mean total cost, and rate of adverse discharge were worse for 30-day (9 days, $64,520, 71.7%) compared to 90-day readmission (6 days, $52,183, 56.5%).

Citation:

Rumalla K, Smith KA, Follett KA, Nazzaro JM, Arnold PM. Rates, causes, risk factors, and outcomes of readmission following deep brain stimulation for movement disorders: Analysis of the U.S. Nationwide Readmissions Database. Clin Neurol Neurosurg. 2018;171:129-134. doi:10.1016/j.clineuro.2018.06.013.

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