• Kelly A Shaftel, Jubran H Jubran, Tyler S Cole, and Andrew S Little.
• Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
• Neurosurgery. 2022 Dec 1; 91 (6): 892899892-899.

BackgroundNontraumatic subdural hematoma (SDH) is a common neurological disease that causes extensive morbidity and mortality. Craniotomy or burr hole craniostomy (BHC) is indicated for symptomatic lesions, but both are associated with high recurrence rates. Although extensive research exists on postoperative complications after BHCs, few studies have examined the underlying causes and predictors of unplanned 30-day hospital readmissions at the national level.ObjectiveTo compare causes for hospital readmission within 30 days after surgical SDH evacuation with BHC and evaluate readmission rates and independent predictors of readmission.MethodsThis retrospective cohort observational study was designed using the Nationwide Readmissions Database. We identified patients who had undergone BHC for SDH evacuation (2010-2015). National estimates and variances within the cohort were calculated after stratifying, hospital clustering, and weighting variables.ResultsWe analyzed 2753 patients who had BHC for SDH evacuation: 675 (24.5%) had at least one 30-day readmission. Annual readmission rates did not vary across the study period ( P = .60). The most common cause of readmission was recurrent SDH (n = 630, 93.3%), and the next most common was postoperative infection (n = 12, 1.8%). Comorbidities significantly associated with readmission included fluid and electrolyte disorders, chronic blood loss anemia, chronic obstructive pulmonary disease, depression, liver disease, and psychosis ( P ≤ .04), but statistically significant independent predictors for readmission included only chronic obstructive pulmonary disease and fluid and electrolyte disorders ( P ≤ .007).ConclusionThese national trends in 30-day readmission rates after nontraumatic SDH evacuation by BHC not otherwise published provide quality benchmarks that can aid national quality improvement efforts.Copyright © Congress of Neurological Surgeons 2022. All rights reserved.

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