INTRODUCTION Deep brain stimulation (DBS) surgery is an efficacious, underutilized treatment for Parkinson's disease (PD). Studies of DBS post-operative outcomes are often restricted to data from a single center and consider DBS in isolation. National estimates of DBS readmission and post-operative outcomes are needed, as are comparisons to commonly performed surgeries. METHODS This study used datasets from the 2013 and 2014 Nationwide Readmissions Database (NRD). Our sample was restricted to PD patients discharged alive after hospitalization for DBS surgery. Descriptive analyses examined patient, clinical, hospital and index hospitalization characteristics. The all-cause, non-elective 30-day readmission rate after DBS was calculated, and logistic regression models were built to examine factors associated with readmission. Readmission rates for the most common surgical procedures were calculated and compared to DBS. RESULTS There were 6058 DBS surgeries for PD in our sample, most often involving a male aged 65 and older, who lived in a high socioeconomic status zip code. DBS patients had an average of four comorbidities. With respect to outcomes, the majority of patients were discharged home (95.3%). Non-elective readmission was rare (4.9%), and was associated with socioeconomic status, comorbidity burden, and teaching hospital status. Much higher acute, non-elective readmission rates were observed for common procedures such as upper gastrointestinal endoscopy (16.2%), colonoscopy (14.0%), and cardiac defibrillator and pacemaker procedures (11.1%). CONCLUSION Short-term hospitalization outcomes after DBS are generally favorable. Socioeconomic disparities in DBS use persist. Additional efforts may be needed to improve provider referrals for and patient access to DBS.

中文翻译：

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深部脑刺激手术治疗帕金森氏病后的急性再入院：全国分析。

简介深部脑刺激（DBS）手术是一种有效的，未得到充分利用的帕金森氏病（PD）治疗方法。DBS术后结局的研究通常仅限于来自单个中心的数据，并单独考虑DBS。需要对DBS的再入院率和术后结果进行全国评估，并且需要与通常进行的手术进行比较。方法本研究使用了2013年和2014年全国再入学数据库（NRD）的数据集。我们的样本仅限于DBS手术住院后出院的PD患者。描述性分析检查了患者，临床，医院和指数住院特征。计算DBS后的全因，非选修的30天再入院率，并建立逻辑回归模型以检查与再入院相关的因素。计算出最常见的外科手术再入院率，并与DBS进行比较。结果我们的样本中有6058件针对PD的DBS DBS手术，其中大多数是65岁及以上的男性，其居住在一个具有较高社会经济地位的邮政编码。DBS患者平均有四种合并症。就结局而言，大多数患者已出院（95.3％）。非选修再入院率极低（4.9％），并与社会经济状况，合并症负担和教学医院状况相关。对于常见的手术，如上消化道内窥镜检查（16.2％），结肠镜检查（14.0％）以及心脏除颤器和起搏器手术（11.1％），观察到的急性，非选择性再入院率更高。结论DBS后短期住院治疗总体上是有利的。DBS使用中的社会经济差异仍然存在。可能需要做出额外的努力来改善提供者对DBS的推荐以及患者对DBS的访问。