Mortality and Discharge to Home After Closed Brain Biopsy: Analysis of 3523 Cases from the State of California, 2003-2009

Objective Closed (percutaneous) brain biopsy is an important diagnostic procedure. Information on patient outcomes after biopsy come largely from single-institution series or population-based samples that include patients treated during periods that may not reflect current neurosurgical practice. We sought to determine the rates of in-hospital mortality and discharge to home after closed brain biopsy, and predictors of these outcomes by using a large population-based hospital discharge database with near-complete case ascertainment. Methods All closed brain biopsies performed in nonfederal hospitals within the State of California between 2003 and 2009 were identified from a discharge database. Adult patients admitted from home were analyzed; patient-level and hospital-level factors were reviewed for predictors of in-hospital mortality and discharge to home. Logistic regression was used to determine significant predictors of outcome. Results During the 7-year period, 3523 hospitalizations, including closed brain biopsy, met our inclusion criteria. Overall in-hospital mortality rate was 3.5%, and 67.2% of hospitalizations were followed by discharge directly to home. Scheduled versus unscheduled admission and patient race were predictors of mortality in multivariate analysis. Patient age, hospital biopsy volume, scheduled versus unscheduled admission, and patient race were predictors of discharge to home. Conclusions Closed brain biopsy is associated with a greater rate of mortality than is generally recognized. Most patients are able to return to home directly after biopsy, but the rate of discharge to home is lower at hospitals with lower procedure volumes.