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

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.