Causes and Predictors of Unplanned Readmission in Cranial Neurosurgery.

Abstract Objective A better understanding of the risks and reasons for unplanned readmission is an essential component in reducing costs in the health care system and in optimizing patient safety and satisfaction. The reasons for unplanned readmission vary between different disciplines and procedures. The aim of this study was to identify reasons for readmission in view of different diagnoses in cranial neurosurgery. Methods In this single centre, retrospective study, adult patients after neurosurgical treatment were analyzed and grouped according to the indication based on ICD-10-GM diagnosis codes. The main outcome measure was unplanned readmission within 30 days of discharge. Further logistic regression models were performed to identify factors associated with unplanned re-hospitalization. Results Out of the 2474 patients analyzed, 183 were re-hospitalized unplannedly. Readmission rates differed between the diagnosis groups, with 9.19% in neoplasm, 8.26% in hydrocephalus, 5.76% in vascular, 6.13% after trauma and 8.05% in the functional group. A number of causes were considered to be preventable, such as wound healing disorders, seizures or social reasons. Younger age, length of first stay, surgical treatment and side diagnoses were predictors for unplanned readmission. Diagnoses with an increased risk of readmission were glioblastoma, traumatic subdural hematoma or chronic subdural hematoma. Conclusion Reasons and predictors for an unplanned readmission differ considerably between the index diagnosis groups. In addition to well-known reasons for readmission, we identified the "social indication", meaning a lack of home care, which is particularly prevalent in oncological and elderly patients. A transitional care program could benefit these vulnerable patients.