Centralisation of care for acoustic tumour surgeries?
Reviewed by Gauri Mankekar

Several factors are responsible for readmission after acoustic tumour removal. The authors retrospectively studied the association between hospital, patient and insurance factors with the rate of readmission following acoustic tumour removal in the United States using the Nationwide Readmission Database (NRD). The common causes for readmission included general central nervous system complications or deficits, hydrocephalus, infection and cerebrospinal fluid leakage with otorrhoea or rhinorrhoea. The 30-day and 90-day readmission rate for all complications was 7.7% and 9.1% respectively. A higher volume of surgeries was associated with a significantly decreased rate of readmission. This paper reveals a trend based on analysis of big data. However, the data from NRD was not designed for vestibular schwannoma surgery and it does not follow up patients for more than 11 months. So, the authors’ data does not include information about tumour size and surgical approach, which could answer some questions about readmissions. Besides, centralisation of care at large urban specialised centres may not be practical for patients who have to travel long distances.

Increased hospital surgical volume reduces rate of 30- and 90- day readmission after acoustic neuroma surgery.
Babadjouni R, Wen T, Donoho DA, et al.
NEUROSURGERY
2019;84(3):726-32.