Using administrative data, this study demonstrates a baseline glioma surgery 30-day readmission rate of 13.2% in California for patients who are initially discharged home. This paper highlights the medical histories, perioperative complications, and patient demographic groups that are at an increased risk for readmission within 30 days of home discharge. An analysis of conditions present on readmission that were not present at the index surgical admission, such as infection and seizures, suggests that some readmissions may be preventable. Discharge planning strategies aimed at reducing readmission rates in neurosurgical practice should focus on patient groups at high risk for readmission and comprehensive discharge planning protocols should be implemented to specifically target the mitigation of potentially preventable conditions that are highly associated with readmission.

Eighty-five percent of emergent diverticulitis patients do not recur after initial medical treatment. However, in view of significantly worse outcomes associated with diverticulitis recurrence, resection should be strongly considered for diverticulitis patients older than 50 years or those who present with a complicated clinical picture.

Background Emerging literature has supported the safety of non-operative management of uncomplicated appendicitis. Study Design Patients with emergent, uncomplicated appendicitis were identified by appropriate ICD-9 diagnosis codes in the California Office of Statewide Health Planning and Development (OSHPD) database from 1997 to 2008. Rates of treatment failure, recurrence, and perforation following non-surgical management were calculated. Factors associated with treatment failure, recurrence, and perforation were identified using multivariable logistic regression. Mortality, length of stay, and total charges were compared between treatment cohorts using matched propensity score analysis. Results Among 231,678 patients with uncomplicated appendicitis, the majority (98.5%) were managed operatively. Among the 3,236 non-surgically managed patients who survived to discharge without an interval appendectomy, 5.9% and 4.4% experienced treatment failure or recurrence, respectively, over a median duration of follow up of greater than seven years. There were no mortalities associated with treatment failure or recurrence. The risk of perforation after discharge was approximately 3%. Using multivariable analysis, race and age were significantly associated with the odds of treatment failure. Gender, age, and hospital teaching status were significantly associated with the odds of recurrence. Age and hospital teaching status were significantly associated with the odds of perforation. Matched propensity score analysis indicated that after risk adjustment mortality rates (0.1% vs. 0.3%, p=0.65) and total charges ($23,243 vs. $24,793, p=0.70) were not statistically different between operative and non-operative patients, however, length of stay was significantly greater amongst the non-operative treatment group (2.1 vs. 3.2 days, p<0.001). Conclusions This study suggests that non-operative management of uncomplicated appendicitis may be safe, and prompts further investigations. Comparative effectiveness research using prospective randomized studies may be particularly useful.

The survival advantage for EVAR repair in a statewide population is maintained for 3 years. After 3 years, EVAR repair was associated with higher mortality; however, these mortality differences did not reach statistical significance over the entire study period. Reintervention and late AAA rupture rates are higher after EVAR repair.

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Our results suggest different incidence rates among different ethnicities. We found the highest rates for any oral cleft, isolated cleft palate, and cleft lip with and without palate in the white (non-Hispanic) population. The declining incidence rates during the period of the study (15 years) could be attributed to environmental, demographic, or gene pool factors. However, further studies are needed to investigate this finding.

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