To investigate the causes and rates of readmissions after cranial or epilepsy related neurosurgery. 

Hospital readmissions are associated with increased healthcare costs and worse patient outcomes. Understanding causes for readmission in persons with epilepsy post cranial surgery is important to implement future quality improvement efforts. 

A retrospective cohort study was performed using the 2013 National Readmission Database, a population-based dataset capturing ~50 million of hospitalizations in the USA. The primary outcome of interest was 30-day readmission following neurosurgical intervention in epilepsy. Validated ICD-9-CM diagnostic case definitions were used to identify people with epilepsy. ICD-9-procedure codes were used to identify surgical procedures: resective surgery, responsive neurostimulation (RNS) or deep brain stimulation (DBS), vagus nerve stimulation (VNS), intracranial EEG (iEEG) and radiosurgery and at index admission. Descriptive statistics were used to determine weighted frequencies and cause of 30-day readmission. 

Of the 2231 patients with epilepsy who underwent surgery, 266 (12.3%) were readmitted within 30 days post-surgery. Readmission proportions were as follows: resective surgery 12.4%, RNS/DBS 6.8%, VNS 12.8%, iEEG 8.0%, radiosurgery 11.5%. The top two reasons for readmission were as follows: resective surgery: 1) complications of surgical procedures 2) epilepsy/convulsions; RNS/DBS 1) epilepsy/convulsions, 2) other hereditary and degenerative nervous system conditions; VNS: 1) epilepsy/convulsions, 2) other hereditary and degenerative nervous system conditions; iEEG: 1) epilepsy/convulsions, 2) acute cerebrovascular disease; radiosurgery: 1) epilepsy/convulsions, 2) complications of surgical procedures or medical care.

Patients undergoing epilepsy related neurosurgery have an 12.3% frequency of readmission within 30-days, which is only slightly higher than the readmission rate in the overall NRD cohort (10%). The most common primary reasons for readmission overall were epilepsy/convulsions and complications of surgical procedures or medical care. Further emphasis on patient safety targeting these modifiable factors and optimization of discharge planning would likely reduce the occurrence of readmissions.