Abstract
Background Thirty-day readmission has become a significant health care metric reflecting the
quality of care and on the cost of service delivery. There is little data on the impact
of complications following skull base surgery (SBS) on emergency readmission. Identifying
modifiable risk factors for readmission may improve care and reduce cost.
Design The study was designed as a single-center retrospective cohort study.
Methods Records for a consecutive series of 165 patients who underwent open or endoscopic
SBS by a single surgeon reviewed. Patients with pituitary adenoma were excluded. The
diagnosis, procedure, complications, length of stay (LOS), body mass index (BMI),
and smoking status were recorded. Readmission to the neurosurgical department or regional
hospitals was either noted prospectively or the patient contacted. Cause and length
of readmission was documented.
Results Of the 165 cases, 14 (8.5%) were readmitted within 30 days. Causes for readmission
included cerebrospinal fluid (CSF) leak in 5/14 or 35.7% (overall rate for readmission
for this complication in the series is 3.1%), infection in 4/14 (28.6%), hyponatraemia
in 2/14 (14.3%), vascular: sinus thrombosis in 1/14 (7.1%), seizures in 1/14 (7.1%),
and epistaxis in 1/14 (7.1%). Initial and readmission LOS was 6 and 14 days, respectively.
BMI was higher in those readmitted within 30 days (33.2 kg/m2) versus no readmission (27.1 kg/m2). In addition, of those readmitted within 30 days, 35.7% were smokers compared with
20.8% in those not readmitted.
Conclusion In this series, smoking and raised BMI may be indicators for within 30-day readmission
and complications in this population, raising the question of risk factor modification
prior to elective intervention.
Keywords
skull base - 30-day readmission - smoking - obesity
