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Factors That Affect Length of Hospital Stay After Vestibular Schwannoma Surgery

Vorasubin, Nopawan*; Alexander, Thomas H.; Mastrodimos, Bill*; Cueva, Roberto A.*

doi: 10.1097/MAO.0000000000001960
MEDICAL NEUROTOLOGY

Objective: To identify perioperative factors that influence hospital length of stay (LOS) after resection of vestibular schwannoma (VS).

Study Design: Retrospective case review.

Setting: Tertiary skull base referral center.

Patients: Patients who underwent acoustic neuroma resection between January 1, 2007 and January 1, 2014.

Interventions: Approaches used for VS resection included translabyrinthine and retrosigmoid.

Main Outcome Measures: LOS and several perioperative factors that may delay hospital discharge were examined. Factors included were patient demographics (age and sex), tumor characteristics (size), surgical factors (operative time, approach, revision surgery, date of surgery), and immediate postoperative factors (presence of vertigo or immediate postoperative complications).

Results: Two hundred eighty-eight patients underwent VS resection during the study period. Two hundred fifty-five patients had complete charts available for review. LOS ranged from 1 to 10 days with an average of 2.66 days and mode of 2 days. One hundred thirty-one patients were admitted for ≤2 days and 124 patients stayed longer. Of the perioperative factors examined with univariate analysis, female gender (p = 0.0266) and presence of postoperative vertigo (p < 0.0001) were statistically significant factors associated with LOS >2 days. On multivariate logistic regression analysis with odds ratios (OR), older patient age (OR = 1.028, p = 0.0177), female gender (OR = 1.810, p = 0.0314), longer operative time (OR = 1.424, p = 0.0007), and presence of postoperative vertigo (OR = 4.904, p < 0.0001) carried a statistically significant increased odds toward a LOS >2 days.

Conclusions: VS surgery and postoperative care can be carried out efficiently with a minimal LOS. Identifying factors that may prolong LOS may help the operative team anticipate and address needs to optimize LOS.

*Southern California Permanente Medical Group, Pasadena

Scripps Clinic Medical Group, La Jolla, California

Address correspondence and reprint requests to Nopawan Vorasubin, M.D., 4900 Sunset Blvd, 6th floor, Los Angeles, CA 90027; E-mail: nopawan.vorasubin@kp.org

The authors disclose no conflicts of interest.

Copyright © 2018 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company