Deep brain stimulation within a multi-center US-based healthcare system - A descriptive epidemiologic review from...

Area of Science:

• Neurosurgery
• Neurology
• Medical Technology

Background:

• Deep brain stimulation (DBS) is advancing, necessitating understanding of practice variations and outcomes in community settings.
• This study examines a 12-year cohort of DBS patients within a large, integrated US healthcare system.

Purpose of the Study:

• To describe patient characteristics and outcomes following DBS placement.
• To analyze practice variations and trends in DBS implantation over a decade.

Main Methods:

• Electronic health records identified 1,158 patients undergoing initial DBS placement (2010-2021).
• Kaplan-Meier methods estimated cumulative probabilities for implantable pulse generator (IPG) replacement, reoperation, and mortality.
• 90-day incidence of emergency department (ED) visits and readmissions was calculated.

Main Results:

• Bilateral systems were implanted in 769 patients, unilateral in 389.
• 90-day outcomes included 14.3% ED visits, 8.5% readmissions, and 1.2% infections.
• At 3 years, 14.5% required IPG replacement and 18.1% underwent reoperation; 5-year mortality was 9.3%.

Conclusions:

• Practice variations in DBS implantation were observed over the study period.
• Utilization of rechargeable DBS systems increased over time.
• Further research is needed to identify modifiable risk factors for adverse outcomes like readmissions and reoperations.