Reframing the Risks of Deep Brain Stimulation: A Comparison of 2.8 Million Elective Surgeries From the NSQIP Database

Area of Science:

• Neurosurgery
• Surgical Safety
• Comparative Effectiveness

Background:

• Deep brain stimulation (DBS) is an effective treatment for various neurological conditions but is underutilized due to safety concerns.
• Comparing DBS safety to common elective procedures is crucial for risk assessment.

Purpose of the Study:

• To compare the safety of deep brain stimulation (DBS) with other common elective surgical procedures.
• To provide context for the relative risk of DBS surgery.

Main Methods:

• Retrospective cohort study using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database (2015-2021).
• Comparison of 4,749 DBS procedures with 2,853,662 patients undergoing 16 common elective procedures.
• Inverse probability of treatment weighting (IPTW) used to adjust for baseline heterogeneity.

Main Results:

• DBS patients had significantly lower 30-day postoperative complication rates (1.3% vs. 4.1%).
• Readmission rates were similar between DBS and other procedures (2.2% vs. 2.6%).
• DBS cases showed higher odds of discharge home and lower reoperation rates.

Conclusions:

• Deep brain stimulation (DBS) exhibits a favorable safety profile compared to widely performed elective surgeries.
• Findings support increased consideration of DBS for eligible patients.
• DBS demonstrates lower complication and reoperation rates, enhancing its perceived safety.