Objective:

We aim to quantify readmission rates following neurosurgical intervention for drug resistant epilepsy (DRE). Readmission risk was also stratified based on type of intervention.

Background:

Hospital readmissions following index admission have become a commonly tracked quality measure aimed at reducing readmission burden and improving post-discharge care. Though commonly studied in other fields, readmission rates following surgical intervention for treatment-resistant epilepsy have not been quantified thus far. 

Design/Methods:

30-day readmissions following surgical intervention for DRE at a single major epilepsy referral center were tracked over a five-year period from January 2017 to March 2022. Subjects were stratified into device, resection, or laser interstitial thermal therapy (LITT) groups.

Results:

Of 570 total subjects, 301 (52.8%) underwent device implantation, 208 (36.5%) underwent tissue resection, and 61 (10.7%) underwent LITT. 94 subjects (17%) were readmitted within 30 days of discharge. 59 subjects (10.4%) were admitted following evaluation in the emergency department (ED); 35 subjects (6.1%) were direct admissions. Among re-admitted subjects, 44 had device implantation, 36 underwent surgical resection, and 14 underwent LITT. 4 subjects (0.70%) had two or more admissions. After adjusting for age, sex, and post-operative risk factors, subjects undergoing device implantation were less likely to be readmitted from the ED within 30 days of index admission compared to subjects undergoing resection [OR: 0.523, 95% CI: 0.286-0.948, p=0.0328], but no significant difference was observed between subjects receiving LITT versus resection [OR: 1.314, 95% CI: 0.583-2.894, p=0.4739]. 

Conclusions:

The overall 30-day readmission rate from the ED following surgical intervention for DRE is 17.0%. Resection-based procedures were associated with higher 30-day readmission rates compared to device implantation.