Factors associated with unplanned readmissions and costs following resection of brain metastases in the United States

Abstract The purpose of this study was to critically analyze the risk of unplanned readmission following resection of brain metastasis and to identify key risk factors to allow for early intervention strategies in high-risk patients. We analyzed data from the Nationwide Readmissions Database (NRD) f...

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Autores principales:	Raees Tonse, Alexandra Townsend, Muni Rubens, Vitaly Siomin, Michael W. McDermott, Martin C. Tom, Matthew D. Hall, Yazmin Odia, Manmeet S. Ahluwalia, Minesh P. Mehta, Rupesh Kotecha
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/f264947bd8784d7692229288e5992275
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spelling	oai:doaj.org-article:f264947bd8784d7692229288e59922752021-11-14T12:20:27ZFactors associated with unplanned readmissions and costs following resection of brain metastases in the United States10.1038/s41598-021-01641-42045-2322https://doaj.org/article/f264947bd8784d7692229288e59922752021-11-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-01641-4https://doaj.org/toc/2045-2322Abstract The purpose of this study was to critically analyze the risk of unplanned readmission following resection of brain metastasis and to identify key risk factors to allow for early intervention strategies in high-risk patients. We analyzed data from the Nationwide Readmissions Database (NRD) from 2010–2014, and included patients who underwent craniotomy for brain metastasis, identified using ICD-9-CM diagnosis (198.3) and procedure (01.59) codes. The primary outcome of the study was unplanned 30-day all-cause readmission rate. Secondary outcomes included reasons and costs of readmissions. Hierarchical logistic regression model was used to identify the factors associated with 30-day readmission following craniotomy for brain metastasis. During the study period, 44,846 index hospitalizations occurred for patients who underwent resection of brain metastasis. In this cohort, 17.8% (n = 7,965) had unplanned readmissions within the first 30 days after discharge from the index hospitalization. The readmission rate did not change significantly during the five-year study period (p-trend = 0.286). The median per-patient cost for 30-day unplanned readmission was $11,109 and this amounted to a total of $26.4 million per year, which extrapolates to a national expenditure of $269.6 million. Increasing age, male sex, insurance status, Elixhauser comorbidity index, length of stay, teaching status of the hospital, neurological complications and infectious complications were associated with 30-day readmission following discharge after an index admission for craniotomy for brain metastasis. Unplanned readmission rates after resection of brain metastasis remain high and involve substantial healthcare expenditures. Developing tools and interventions to prevent avoidable readmissions could focus on the high-risk patients as a future strategy to decrease substantial healthcare expense.Raees TonseAlexandra TownsendMuni RubensVitaly SiominMichael W. McDermottMartin C. TomMatthew D. HallYazmin OdiaManmeet S. AhluwaliaMinesh P. MehtaRupesh KotechaNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Raees Tonse Alexandra Townsend Muni Rubens Vitaly Siomin Michael W. McDermott Martin C. Tom Matthew D. Hall Yazmin Odia Manmeet S. Ahluwalia Minesh P. Mehta Rupesh Kotecha Factors associated with unplanned readmissions and costs following resection of brain metastases in the United States
description	Abstract The purpose of this study was to critically analyze the risk of unplanned readmission following resection of brain metastasis and to identify key risk factors to allow for early intervention strategies in high-risk patients. We analyzed data from the Nationwide Readmissions Database (NRD) from 2010–2014, and included patients who underwent craniotomy for brain metastasis, identified using ICD-9-CM diagnosis (198.3) and procedure (01.59) codes. The primary outcome of the study was unplanned 30-day all-cause readmission rate. Secondary outcomes included reasons and costs of readmissions. Hierarchical logistic regression model was used to identify the factors associated with 30-day readmission following craniotomy for brain metastasis. During the study period, 44,846 index hospitalizations occurred for patients who underwent resection of brain metastasis. In this cohort, 17.8% (n = 7,965) had unplanned readmissions within the first 30 days after discharge from the index hospitalization. The readmission rate did not change significantly during the five-year study period (p-trend = 0.286). The median per-patient cost for 30-day unplanned readmission was $11,109 and this amounted to a total of $26.4 million per year, which extrapolates to a national expenditure of $269.6 million. Increasing age, male sex, insurance status, Elixhauser comorbidity index, length of stay, teaching status of the hospital, neurological complications and infectious complications were associated with 30-day readmission following discharge after an index admission for craniotomy for brain metastasis. Unplanned readmission rates after resection of brain metastasis remain high and involve substantial healthcare expenditures. Developing tools and interventions to prevent avoidable readmissions could focus on the high-risk patients as a future strategy to decrease substantial healthcare expense.
format	article
author	Raees Tonse Alexandra Townsend Muni Rubens Vitaly Siomin Michael W. McDermott Martin C. Tom Matthew D. Hall Yazmin Odia Manmeet S. Ahluwalia Minesh P. Mehta Rupesh Kotecha
author_facet	Raees Tonse Alexandra Townsend Muni Rubens Vitaly Siomin Michael W. McDermott Martin C. Tom Matthew D. Hall Yazmin Odia Manmeet S. Ahluwalia Minesh P. Mehta Rupesh Kotecha
author_sort	Raees Tonse
title	Factors associated with unplanned readmissions and costs following resection of brain metastases in the United States
title_short	Factors associated with unplanned readmissions and costs following resection of brain metastases in the United States
title_full	Factors associated with unplanned readmissions and costs following resection of brain metastases in the United States
title_fullStr	Factors associated with unplanned readmissions and costs following resection of brain metastases in the United States
title_full_unstemmed	Factors associated with unplanned readmissions and costs following resection of brain metastases in the United States
title_sort	factors associated with unplanned readmissions and costs following resection of brain metastases in the united states
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/f264947bd8784d7692229288e5992275
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Factors associated with unplanned readmissions and costs following resection of brain metastases in the United States

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