TY - JOUR
T1 - Comorbid depression associated with non-routine discharge following craniotomy for low-grade gliomas and benign tumors – a nationwide readmission database analysis
AU - Jarvis, Casey A.
AU - Lin, Michelle
AU - Ding, Li
AU - Julian, Alex
AU - Giannotta, Steven L.
AU - Zada, Gabriel
AU - Mack, William J.
AU - Attenello, Frank J.
N1 - Funding Information:
The National Institute of Health provided funding support in the form of the NIH SC CTSI KL2 Clinical and Translational Research Scholar Grant awarded to Dr. Attenello. The sponsor had no role in the design or conduct of this research.
Publisher Copyright:
© 2020, Springer-Verlag GmbH Austria, part of Springer Nature.
PY - 2020/11/1
Y1 - 2020/11/1
N2 - Purpose: Prior studies have demonstrated elevated rates of depression in patients with malignant brain tumor; however, the prevalence and effect on surgical outcomes in patients with low-grade gliomas (LGG) and benign brain tumors (BBT) remain unknown. Readmission and non-routine discharge, which includes discharge to skilled nursing, rehabilitative, and other inpatient facilities, are well-established quality of care indicators. We sought to analyze the association between comorbid depression and non-routine discharge, readmission, and other post-operative inpatient outcomes in patients with LGG and BBT. Methods: The Nationwide Readmissions Database from 2010 to 2014 was retrospectively queried to select for surgically treated patients with LGG and BBT. Multivariable logistic regression models adjusting for patient and hospital characteristics were used to determine the effects of comorbid depression on post-operative outcomes. Interaction of gender and depression on non-routine disposition was analyzed. Results: We identified 31,654 craniotomies for resection of BBT and LGG (2010–2014). The majority of patients (64.1%) were female. The rate of depression comorbid with BBT and LGG was 11.9%. Depression was associated with non-routine discharge after surgery (OR 1.19, p 0.0002*), but was not associated with increased morbidity, mortality, or readmission at 30 or 90 days. The rate of comorbid depression was higher among female than male patients (14.0 vs. 8.0%). Depression in males was associated with a 38% increased likelihood of non-routine disposition (p = 0.0002*), while depression in females was associated with a 13% increased likelihood of non-routine disposition (p = 0.03*). Conclusion: Depression is prevalent in patients with LGG and BBT and is associated with increased risk of non-routine discharge following surgical intervention. The increased likelihood of non-routine disposition is greater for males than that for females. Awareness of the risk factors for depression may aid in early screening and intervention and improve overall patient outcomes.
AB - Purpose: Prior studies have demonstrated elevated rates of depression in patients with malignant brain tumor; however, the prevalence and effect on surgical outcomes in patients with low-grade gliomas (LGG) and benign brain tumors (BBT) remain unknown. Readmission and non-routine discharge, which includes discharge to skilled nursing, rehabilitative, and other inpatient facilities, are well-established quality of care indicators. We sought to analyze the association between comorbid depression and non-routine discharge, readmission, and other post-operative inpatient outcomes in patients with LGG and BBT. Methods: The Nationwide Readmissions Database from 2010 to 2014 was retrospectively queried to select for surgically treated patients with LGG and BBT. Multivariable logistic regression models adjusting for patient and hospital characteristics were used to determine the effects of comorbid depression on post-operative outcomes. Interaction of gender and depression on non-routine disposition was analyzed. Results: We identified 31,654 craniotomies for resection of BBT and LGG (2010–2014). The majority of patients (64.1%) were female. The rate of depression comorbid with BBT and LGG was 11.9%. Depression was associated with non-routine discharge after surgery (OR 1.19, p 0.0002*), but was not associated with increased morbidity, mortality, or readmission at 30 or 90 days. The rate of comorbid depression was higher among female than male patients (14.0 vs. 8.0%). Depression in males was associated with a 38% increased likelihood of non-routine disposition (p = 0.0002*), while depression in females was associated with a 13% increased likelihood of non-routine disposition (p = 0.03*). Conclusion: Depression is prevalent in patients with LGG and BBT and is associated with increased risk of non-routine discharge following surgical intervention. The increased likelihood of non-routine disposition is greater for males than that for females. Awareness of the risk factors for depression may aid in early screening and intervention and improve overall patient outcomes.
KW - Benign brain tumor
KW - Craniotomy
KW - Depression
KW - Non-routine discharge
KW - Readmission
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U2 - 10.1007/s00701-020-04559-4
DO - 10.1007/s00701-020-04559-4
M3 - Article
C2 - 32876766
AN - SCOPUS:85090195622
SN - 0001-6268
VL - 162
SP - 2671
EP - 2681
JO - Acta Neurochirurgica
JF - Acta Neurochirurgica
IS - 11
ER -