J Neurol Surg B
DOI: 10.1055/s-0039-1684034
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Smoking and Obesity are Risk Factors for Thirty-Day Readmissions Following Skull Base Surgery

1  Department of Neurosurgery, University Hospital of Wales, Cardiff, United Kingdom
,
Peter N. Taylor
2  Thyroid Research Group, Systems Immunity Research Institute, Cardiff University School of Medicine, Cardiff, United Kingdom
,
Benjamin T. Stew
3  Department of Otolaryngology, Head and Neck Surgery, University Hospital of Wales, Cardiff, United Kingdom
,
Geoffrey Shone
3  Department of Otolaryngology, Head and Neck Surgery, University Hospital of Wales, Cardiff, United Kingdom
,
Caroline Hayhurst
1  Department of Neurosurgery, University Hospital of Wales, Cardiff, United Kingdom
› Author Affiliations
Further Information

Publication History

09 August 2018

25 February 2019

Publication Date:
02 April 2019 (online)

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.

Disclosure

Some results contained in this paper were presented at EndoBarcelona 2018.


Supplementary Material