PMID- 29209875
OWN - NLM
STAT- MEDLINE
DCOM- 20190304
LR  - 20190304
IS  - 1573-7373 (Electronic)
IS  - 0167-594X (Print)
IS  - 0167-594X (Linking)
VI  - 136
IP  - 3
DP  - 2018 Feb
TI  - Non-routine discharge disposition is associated with post-discharge complications 
      and 30-day readmissions following craniotomy for brain tumor resection.
PG  - 595-604
LID - 10.1007/s11060-017-2689-0 [doi]
AB  - Several studies have reported an association between high-volume brain tumor 
      centers and greater rates of routine discharge disposition in the context of 
      better outcomes. However, the relationship between in-hospital complications, 
      discharge destination, and postoperative adverse events (AEs) remains unexplored. 
      The purpose of this study was thus to use a large, prospectively collected 
      database to examine the association between discharge destination, post-discharge 
      complications, readmissions, and reoperations among patients undergoing 
      craniotomy for brain tumor. The 2011-2014 National Surgical Quality Improvement 
      (NSQIP) database was employed to identify all adult patients who underwent a 
      craniotomy for brain tumor resection. Demographics, comorbidities, and 
      perioperative variables were collected for each patient. Univariate statistics 
      with subsequent binary logistic regression analyses were used to explore the 
      relationship between these perioperative factors and postoperative events, 
      including major post-discharge complications, minor post-discharge AEs, 
      readmissions, and return to the operating room (ROR). Significant variables such 
      as demographics, comorbidities, operative time, body mass index, ASA 
      classification and pre-discharge complications were controlled for in each model. 
      Of the 14,854 patients identified, 11,409 (77.9%) were discharged home. After 
      controlling for comorbidities and in-hospital AEs, discharge to skilled 
      rehabilitation was an independent predictor of major post-discharge complications 
      (OR 1.74, 95% CI 1.31-2.30, p < 0.001), minor post-discharge events (OR 1.60, 95% 
      CI 1.07-2.41, p = 0.024), and ROR (OR 1.68, 95% CI 1.27-2.22, p < 0.001). 
      Discharge to a care facility was predictive of major complications (OR 1.51, 95% 
      CI 1.04-2.19, p = 0.030) and ROR (OR 2.02, 95% CI 1.46-2.80, p < 0.001). These 
      factors may be considered in discharge planning and further outcomes studies for 
      patients undergoing resection.
FAU - Lakomkin, Nikita
AU  - Lakomkin N
AUID- ORCID: 0000-0003-4103-1033
AD  - Department of Neurosurgery, Icahn School of Medicine, Mount Sinai, Mount Sinai 
      Health System, New York, USA.
AD  - Department of Neurosurgery, Icahn School of Medicine, Mount Sinai Beth Israel, 
      Mount Sinai Health System, New York, USA.
FAU - Hadjipanayis, Constantinos G
AU  - Hadjipanayis CG
AD  - Department of Neurosurgery, Icahn School of Medicine, Mount Sinai, Mount Sinai 
      Health System, New York, USA. Constantinos.Hadjipanayis@mountsinai.org.
AD  - Department of Neurosurgery, Icahn School of Medicine, Mount Sinai Beth Israel, 
      Mount Sinai Health System, New York, USA. 
      Constantinos.Hadjipanayis@mountsinai.org.
AD  - Mount Sinai Beth Israel - Phillips Ambulatory Care Center, 10 Union Square East, 
      Suite 5E, New York, NY, 10003, USA. Constantinos.Hadjipanayis@mountsinai.org.
LA  - eng
GR  - R01 CA176659/CA/NCI NIH HHS/United States
PT  - Journal Article
DEP - 20171205
PL  - United States
TA  - J Neurooncol
JT  - Journal of neuro-oncology
JID - 8309335
SB  - IM
MH  - Brain Neoplasms/epidemiology/rehabilitation/*surgery
MH  - Comorbidity
MH  - *Craniotomy/adverse effects
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Patient Discharge
MH  - *Patient Readmission
MH  - Postoperative Complications/*epidemiology
MH  - Quality Improvement
MH  - Risk Factors
MH  - Time Factors
PMC - PMC5898927
MID - NIHMS925022
OTO - NOTNLM
OT  - Adverse events
OT  - Discharge destination
OT  - Morbidity
OT  - NSQIP
OT  - Readmissions
COIS- Conflicts of Interest and Source of Funding: None
EDAT- 2017/12/07 06:00
MHDA- 2019/03/05 06:00
PMCR- 2019/02/01
CRDT- 2017/12/07 06:00
PHST- 2017/04/17 00:00 [received]
PHST- 2017/11/18 00:00 [accepted]
PHST- 2017/12/07 06:00 [pubmed]
PHST- 2019/03/05 06:00 [medline]
PHST- 2017/12/07 06:00 [entrez]
PHST- 2019/02/01 00:00 [pmc-release]
AID - 10.1007/s11060-017-2689-0 [pii]
AID - 10.1007/s11060-017-2689-0 [doi]
PST - ppublish
SO  - J Neurooncol. 2018 Feb;136(3):595-604. doi: 10.1007/s11060-017-2689-0. Epub 2017 
      Dec 5.