Determining the Impact of Preoperative Psychiatric Comorbidities on Readmission After Resection of Vestibular Schwannoma

Abstract

Objective To determine the impact of comorbid depression on readmission after vestibular schwannoma resection. Study design Retrospective database analysis. Setting National database of readmitted patients. Patients The Nationwide Readmission Database (NRD) was retrospectively reviewed for patients with history of vestibular schwannoma, identified by International Classification of Disease, Ninth Revision (ICD-9) code 225.1 and ICD-10 code D33.3, who underwent surgical resection (ICD-9 04.01, ICD-10-PCS 00BN0ZZ) in 2020. Interventions Therapeutic. Main outcome measures Need for rehabilitation, need for procedures, length of stay, cost of readmission, and insurance status. Results A total of 1997 patients were readmitted after resection of vestibular schwannoma in 2020. Of these patients, 290 had history of a comorbid depressive disorder. A significantly higher proportion of patients with history of comorbid depression were transferred to a rehabilitation facility after readmission (11.30% versus 4.30%, p < 0.001). Length of stay (p = 0.227) and total readmission cost (p = 0.723) did not differ significantly, but a significantly lower proportion had private insurance (55.40% versus 64.40%, p = 0.027). Conclusion Depression is associated with higher utilization of postoperative rehabilitation services and higher rates of medical comorbidities, and should be considered during preoperative evaluation.