Top

Published in:

01-11-2020 | Meningioma | Original Article - Tumor - Meningioma

Predictors of readmission after craniotomy for meningioma resection: a nationwide readmission database analysis

Authors: Michelle Lin, Elliot Min, Elliott A. Orloff, Li Ding, Kerolos S. R. Youssef, James S. Hu, Steven L. Giannotta, William J. Mack, Frank J. Attenello

Published in: Acta Neurochirurgica | Issue 11/2020

Abstract

Background

Meningiomas are the most common benign primary brain tumors. The mainstay of treatment, surgical resection, is often curative. Given the excellent prognosis of these lesions, minimizing perioperative complications is of the utmost importance. With the establishment of the National Readmissions Database (NRD), researchers are now able to identify variables associated with postoperative complications beyond the index admission.

Objective

In this study, we sought to identify the leading causes for non-elective readmission and variables associated with increased likelihood of readmission at 30 and 90 days after discharge following a craniotomy for meningioma resection.

Methods

Adult inpatients who underwent craniotomy for meningioma resection between 2010 and 2014 were queried from the NRD. All-cause readmissions following craniotomy at 30 and 90 days were identified, and a multivariable logistic regression model was used to characterize independent risk factors.

Results

Among 26,034 patients who received craniotomy for meningioma resection, 2825 (10.9%) were readmitted at 30 days and 3436 (16.1%) were readmitted at 90 days. Postoperative wound infection was the most common readmission diagnosis, occurring in 9.32% and 10.2% of 30- and 90-day readmissions respectively. Patient factors associated with increased likelihood of readmission included male gender, greater illness severity, non-routine discharge, index length of hospitalization, and having Medicare or Medicaid insurance.

Conclusions

Readmission following craniotomy for meningioma resection occurs at a clinically significant rate. Several patient factors were identified in association with all-cause 30- and 90-day readmissions. Further studies are required to identify means for preventing complications following discharge in these vulnerable patient populations.

Adler NE, Boyce WT, Chesney MA, Folkman S, Syme SL (1993) Socioeconomic inequalities in health. No easy solution. JAMA 269(24):3140–3145PubMed

Aghi MK, Eskandar EN, Carter BS, Curry WT, Barker FG (2007) Increased prevalence of obesity and obesity-related postoperative complications in male patients with meningiomas. Neurosurgery 61(4):754–761PubMed

Ambekar S, Sharma M, Madhugiri VS, Nanda A (2013) Trends in intracranial meningioma surgery and outcome: a Nationwide Inpatient Sample database analysis from 2001 to 2010. J Neuro-Oncol 114(3):299–307

Anthofer J, Wester M, Zeman F, Brawanski A, Schebesch K-M (2016) Case-control study of patients at risk of medical complications after elective craniotomy. World Neurosurg 91:58–65PubMed

Avendano M, Glymour MM (2008) Stroke disparities in older Americans: is wealth a more powerful indicator of risk than income and education? Stroke 39(5):1533–1540PubMedPubMedCentral

Avendano M, Kawachi I, Van Lenthe F, Boshuizen HC, Mackenbach JP, Van den Bos G a M, Fay ME, Berkman LF (2006) Socioeconomic status and stroke incidence in the US elderly: the role of risk factors in the EPESE study. Stroke 37(6):1368–1373PubMed

Babadjouni R, Wen T, Donoho DA et al (2019) Increased hospital surgical volume reduces rate of 30- and 90-day readmission after acoustic neuroma surgery. Neurosurgery 84(3):726–732PubMed

Bagger JP, Zindrou D, Taylor KM (2004) Postoperative infection with meticillin-resistant Staphylococcus aureus and socioeconomic background. Lancet 363(9410):706–708PubMed

Bakshi SC, Fobare A, Benarroch-Gampel J, Teodorescu V, Rajani RR (2019) Lower socioeconomic status is associated with groin wound complications following revascularization for peripheral artery disease. Ann Vasc Surg S0890509619304121

10.

Buchanan IA, Donoho DA, Patel A, Lin M, Wen T, Ding L, Giannotta SL, Mack WJ, Attenello F (2018) Predictors of surgical site infection after nonemergent craniotomy: a Nationwide Readmission Database analysis. World Neurosurg 120:e440–e452PubMedPubMedCentral

11.

Buchanan IA, Lin M, Donoho DA, Patel A, Ding L, Amar AP, Giannotta SL, Mack WJ, Attenello F (2019) Predictors of venous thromboembolism after nonemergent craniotomy: a Nationwide Readmission Database analysis. World Neurosurg 122:e1102–e1110PubMed

12.

Burns EM, Rigby E, Mamidanna R, Bottle A, Aylin P, Ziprin P, Faiz OD (2012) Systematic review of discharge coding accuracy. J Public Health Oxf Engl 34(1):138–148

13.

Byrne RW, Bagan BT, Slavin KV, Curry D, Koski TR, Origitano TC (2008) Neurosurgical emergency transfers to academic centers in Cook County: a prospective multicenter study. Neurosurgery 62(3):709–716 discussion 709-716PubMed

14.

Connolly ID, Cole T, Veeravagu A, Popat R, Ratliff J, Li G (2015) Craniotomy for resection of meningioma: an age-stratified analysis of the MarketScan longitudinal database. World Neurosurg 84(6):1864–1870PubMed

15.

Curry WT, McDermott MW, Carter BS, Barker FG (2005) Craniotomy for meningioma in the United States between 1988 and 2000: decreasing rate of mortality and the effect of provider caseload. J Neurosurg 102(6):977–986PubMed

16.

Curry WT, Carter BS, Barker FG (2010) Racial, ethnic, and socioeconomic disparities in patient outcomes after craniotomy for tumor in adult patients in the United States, 1988-2004. Neurosurgery 66(3):427–437 discussion 437-438PubMed

17.

Cusimano MD, Pshonyak I, Lee MY, Ilie G (2017) A systematic review of 30-day readmission after cranial neurosurgery. J Neurosurg 127(2):342–352PubMed

18.

Dasenbrock HH, Yan SC, Smith TR, Valdes PA, Gormley WB, Claus EB, Dunn IF (2017) Readmission after craniotomy for tumor: a National Surgical Quality Improvement Program analysis. Neurosurgery 80(4):551–562PubMed

19.

Doctor N, Yang S, Maerzacker S, Watkins P, Dissanaike S (2016) Socioeconomic status and outcomes after burn injury. J Burn Care Res 37(1):e56–e62PubMed

20.

Donoho DA, Wen T, Babadjouni RM, Schwartzman W, Buchanan IA, Cen SY, Zada G, Mack WJ, Attenello FJ (2018) Predictors of 30- and 90-day readmission following craniotomy for malignant brain tumors: analysis of nationwide data. J Neuro-Oncol 136(1):87–94

21.

Donoho DA, Buchanan IA, Patel A, Ding L, Cen S, Wen T, Giannotta SL, Attenello F, Mack WJ (2019) Early readmission after ventricular shunting in adults with hydrocephalus: a Nationwide Readmission Database analysis. World Neurosurg S1878875019308976

22.

Dressler EV, Dolecek TA, Liu M, Villano JL (2017) Demographics, patterns of care, and survival in pediatric medulloblastoma. J Neuro-Oncol 132(3):497–506

23.

Flores G (2006) Language barriers to health care in the United States. N Engl J Med 355(3):229–231PubMed

24.

George A, Rubin G (2003) Non-attendance in general practice: a systematic review and its implications for access to primary health care. Fam Pract 20(2):178–184PubMed

25.

Grossman R, Mukherjee D, Chang DC, Bennett R, Brem H, Olivi A, Quiñones-Hinojosa A (2011) Preoperative Charlson comorbidity score predicts postoperative outcomes among older intracranial meningioma patients. World Neurosurg 75(2):279–285PubMed

26.

Horsley BP, Lindauer SJ, Shroff B, Tüfekçi E, Abubaker AO, Fowler CE, Maxfield BJ (2007) Appointment keeping behavior of Medicaid vs non-Medicaid orthodontic patients. Am J Orthod Dentofac Orthop Off Publ Am Assoc Orthod Its Const Soc Am Board Orthod 132(1):49–53

27.

Karhade AV, Fandino L, Gupta S, Cote DJ, Iorgulescu JB, Broekman ML, Aglio LS, Dunn IF, Smith TR (2017) Impact of operative length on post-operative complications in meningioma surgery: a NSQIP analysis. J Neuro-Oncol 131(1):59–67

28.

Kaur G, Stein LK, Boehme A, Liang JW, Tuhrim S, Mocco J, Dhamoon MS (2019) Risk of readmission for infection after surgical intervention for intracerebral hemorrhage. J Neurol Sci 399:161–166PubMed

29.

Kocher RP, Adashi EY (2011) Hospital readmissions and the affordable care act: paying for coordinated quality care. JAMA. https://doi.org/10.1001/jama.2011.1561

30.

Liu M, Thakkar JP, Garcia CR, Dolecek TA, Wagner LM, Dressler EVM, Villano JL (2018) National cancer database analysis of outcomes in pediatric glioblastoma. Cancer Med 7(4):1151–1159PubMedPubMedCentral

31.

Mackenbach JP, Kunst AE, Cavelaars AE, Groenhof F, Geurts JJ (1997) Socioeconomic inequalities in morbidity and mortality in western Europe. The EU Working Group on Socioeconomic Inequalities in Health. Lancet Lond Engl 349(9066):1655–1659

32.

Mackenbach JP, Stirbu I, Roskam A-JR, Schaap MM, Menvielle G, Leinsalu M, Kunst AE (2008) Socioeconomic inequalities in health in 22 European countries. N Engl J Med 358(23):2468–2481PubMed

33.

McKee SP, Yang A, Gray M, Zeiger J, Bederson JB, Govindaraj S, Iloreta AMC, Shrivastava RK (2018) Intracranial meningioma surgery: value-based care determinants in New York state, 1995–2015. World Neurosurg 118:e731–e744PubMed

34.

Merkow RP, Ju MH, Chung JW, Hall BL, Cohen ME, Williams MV, Tsai TC, Ko CY, Bilimoria KY (2015) Underlying reasons associated with hospital readmission following surgery in the United States. JAMA 313(5):483–495PubMed

35.

Mukherjee D, Zaidi HA, Kosztowski T, Chaichana KL, Brem H, Chang DC, Quiñones-Hinojosa A (2010) Disparities in access to neuro-oncologic care in the United States. Arch Surg Chic Ill 1960 145(3):247–253

36.

Mukherjee D, Patil CG, Todnem N, Ugiliweneza B, Nuño M, Kinsman M, Lad SP, Boakye M (2013) Racial disparities in Medicaid patients after brain tumor surgery. J Clin Neurosci Off J Neurosurg Soc Australas 20(1):57–61

37.

Nanda A, Bir SC, Maiti TK, Konar SK, Missios S, Guthikonda B (2017) Relevance of Simpson grading system and recurrence-free survival after surgery for World Health Organization grade I meningioma. J Neurosurg 126(1):201–211PubMed

38.

Nayeri A, Brinson PR, Weaver KD, Thompson RC, Chambless LB (2016) Factors associated with low socioeconomic status predict poor postoperative follow-up after meningioma resection. J Neurol Surg Part B Skull Base 77(3):226–230

39.

Nunno A, Li Y, Pieters TA, Towner JE, Schmidt T, Shi M, Walter K, Li YM (2019) Risk factors and associated complications of symptomatic venous thromboembolism in patients with craniotomy for meningioma. World Neurosurg 122:e1505–e1510PubMed

40.

Ostrom QT, Gittleman H, Truitt G, Boscia A, Kruchko C, Barnholtz-Sloan JS (2018) CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2011–2015. Neuro-Oncol 20(suppl_4):iv1–iv86PubMedPubMedCentral

41.

Patil CG, Veeravagu A, Lad SP, Boakye M (2010) Craniotomy for resection of meningioma in the elderly: a multicentre, prospective analysis from the National Surgical Quality Improvement Program. J Neurol Neurosurg Psychiatry 81(5):502–505PubMed

42.

Pieper B, Templin TN (2015) A cross-sectional pilot study to examine food sufficiency and assess nutrition among low-income patients with injection-related venous ulcers. Ostomy Wound Manage 61(4):32–42PubMed

43.

Rhome R, Fisher R, Hormigo A, Parikh RR (2016) Disparities in receipt of modern concurrent chemoradiotherapy in glioblastoma. J Neuro-Oncol 128(2):241–250

44.

Rumalla K, Smith KA, Follett KA, Nazzaro JM, Arnold PM (2018) 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 171:129–134PubMed

45.

Stupp R, Mason WP, van den Bent MJ et al (2005) Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 352(10):987–996PubMed

46.

Timmins CL (2002) The impact of language barriers on the health care of Latinos in the United States: a review of the literature and guidelines for practice. J Midwifery Womens Health 47(2):80–96PubMed

47.

Whittle IR, Smith C, Navoo P, Collie D (2004) Meningiomas. Lancet Lond Engl 363(9420):1535–1543

48.

Zhang C, Hu G, Biskup E, Qiu X, Zhang H, Zhang H (2018) Depression induced by total mastectomy, breast conserving surgery and breast reconstruction: a systematic review and meta-analysis. World J Surg 42(7):2076–2085PubMed

Title: Predictors of readmission after craniotomy for meningioma resection: a nationwide readmission database analysis
Authors: Michelle Lin
Elliot Min
Elliott A. Orloff
Li Ding
Kerolos S. R. Youssef
James S. Hu
Steven L. Giannotta
William J. Mack
Frank J. Attenello
Publication date: 01-11-2020
Publisher: Springer Vienna
Keywords: Meningioma
Craniotomy
Meningioma
Published in: Acta Neurochirurgica / Issue 11/2020
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-020-04528-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Predictors of readmission after craniotomy for meningioma resection: a nationwide readmission database analysis

Abstract

Background

Objective

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Objective

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 11/2020

The battle against an invisible enemy

Kyphotic deformity of the lumbar spine due to a monostotic fibrous dysplasia of the second lumbar vertebra: a case report and its surgical management

Microvascular decompression for trigeminal neuralgia caused by vertebrobasilar dolichoectasia: interposition technique versus transposition technique

New perspectives in the endoscopic treatment of brain purulent collections: targets, techniques, results in a case series, and overview of the literature

Development of machine learning-based preoperative predictive analytics for unruptured intracranial aneurysm surgery: a pilot study

Surgical management for large vestibular schwannomas: a systematic review, meta-analysis, and consensus statement on behalf of the EANS skull base section