What factors influence the length of stay and readmission after deep brain stimulation surgery? a tertiary centre...

Deep Brain Stimulation (DBS) is a well-established treatment for refractory movement disorders. However, there are surgical risks and it often includes in-patient hospital admission. The aim is to review key factors associated with prolonged length of stay (LoS)(defined here as > 2 nights), and readmission within six months.

We retrospectively reviewed medical records of patients who underwent DBS insertion between October 2016 and September 2024 in our tertiary centre. Patient and operative factors were reviewed.

397 DBS procedures(388 patients) were included. Parkinson's disease (PD) patients constitute majority(73%), followed by Essential Tremor(13%). Mean LoS were 2.39 ± 0.2 and 2.48 ± 0.5 nights, respectively. Within PD cohort, older age and use of blood thinners were associated with increased LoS. Other factors such as gender, baseline Unified Parkinson's Disease Rating Scale-3 score, symptom duration, and operating time were not statistically significant. Readmission rate was 10.3%(41/397), with majority secondary to infection(20/41) or planned readmission(13/41). Excluding planned readmissions, average LoS during readmission was 13.4 ± 0.6 nights, with majority readmitted > 30 days post-discharge (15/27). Within PD, readmission rate was 6.9%(19/276), with skull-mounted implant use identified as risk factor.

This study identified risk factors for prolonged hospital stay after DBS surgeries, with our surgical workflow, in a publicly-funded healthcare system. We also captured factors associated with readmission within six months, which is a much longer timeframe than most studies in literature. This provides information to facilitate prehabilitation, resource allocation, and patient counselling to optimise patient outcome and reduce treatment costs. Further studies are warranted to confirm these findings, especially with different DBS techniques and workflows.