(0914) Complications Following Resection of Vestibular Schwannoma: Analysis of the National Readmissions Database

Introduction: Complications following surgical management of vestibular schwannoma (VS) have been well described, but there is limited literature on the effect of different complications on postoperative readmission. The aim of this study is to determine whether specific surgical complications affect readmission length and complexity.

Methods: The National Readmissions Database was queried for patients with history of VS (ICD-10-CM D33.3) who were readmitted following surgical resection (ICD-10-PCS 00BN0ZZ) in the year 2020. Readmission variables for patients with complications of cerebrospinal fluid (CSF) leakage, wound complications, acute kidney injury (AKI), pneumonia, urinary tract infection (UTI), and sepsis, identified by ICD-9/10 codes were compared. Chi square analysis and t-tests were used for comparison.

Results: During the study period, 1,997 patients were readmitted following VS resection. Longer length of stay and a higher number of procedures were completed for patients with history of CSF leak (p < 0.001, p = 0.077), wound dehiscence (p < 0.001, p < 0.001), AKI (p < 0.001, p = 0.022), PNA (p < 0.001, p < 0.001), and sepsis (p < 0.001, p < 0.001). In addition, significantly higher hospital costs were noted in patients with wound dehiscence, AKI, PNA, UTI, and sepsis (p < 0.001). A significantly higher age and mortality rate were noted in patients with UTI (4.8% vs 0.2, p < 0.001) and sepsis (17% vs 0.2%, p = 0.079), whereas other complications did not differ significantly.

Conclusions: Patients with surgical complications had significantly longer length of hospital stay and more procedures performed during readmission. Those with UTI and sepsis were older and carried a higher mortality rate than other complications.