Socioeconomic Factors Affecting Discharge Status of Patients with Uncomplicated Transsphenoidal Adenohypophysectomy

Journal of Neurological Surgery. Part B, Skull Base
Chelsea S HamillD David Beahm

Abstract

Objectives  The number of transsphenoidal adenohypophysectomies (TSAs) surgeries has grown significantly since 1993. While there has been an overall decreasing trend in length of stay (LOS), socioeconomic factors may impact hospitalization. This study explores the impact of socioeconomic factors on LOS and total charges in uncomplicated patients undergoing TSA. Design  Retrospective cohort. Setting  2009 to 2013 Nationwide Inpatient Sample. Participants  Patients undergoing TSA without medical complications. Main Outcomes Measures  LOS and total charges. Results  A total of 6,457 patients were identified, of which 17.2% had secreting tumors. Patients with secreting tumors stayed 2.95 days versus those with nonsecreting tumors stayed 3.26 days ( p  < 0.001). Discharge to other than self-care was the largest contributing variable for both subsets, increasing both LOS and total charges. Patient factors that drove longer LOS and increased total charges for both subsets included metropolitan domicile, having a lower median income, Hispanic ethnicity, and having an increased amount of Agency for Healthcare Research and Quality (AHRQ) comorbidity indices. Having private insurance predicted a shorter LOS and lower total charges. Conclu...Continue Reading

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