Outpatient Deep Brain Stimulation: Initial Experience

ABSTRACT

Introduction Since the start of the COVID-9 pandemic, inpatient hospital resources have become extremely limited. This has limited access to surgical care for patients, especially for elective surgeries. Deep brain stimulation (DBS) surgery has been known to be very safe with very low rates of serious complications but has typically been accompanied with an inpatient hospital stay. Performing DBS surgery as an outpatient procedure could preserve access to this important treatment option, even during medical scarcity. Methods From March 2020 to January of 2021, stage I DBS surgery was scheduled as outpatient surgery for 19 patients. DBS patients who were scheduled as inpatient admissions were included as a comparison. Cohorts were compared based on time until discharge, early surgical complications, readmissions, emergency department (ED) visits, as well as demographic patient characteristics. Results Eighteen patients underwent a DBS scheduled as an outpatient surgery were compared to 20 patients who were scheduled as inpatient surgeries. Only 1 patient scheduled as an outpatient surgery was admitted overnight. This was due to an asymptomatic hemorrhage seen on routine post op imaging. There were no significant differences between readmissions, ED visits, or complications between the groups. In the outpatient surgery group, there were 2 post op ED visits and no admissions. There were no symptomatic hemorrhages, surgical site infections, readmissions, or reoperations in the outpatient group. The post op admission time for the two groups was 3.72h (+/-1.11) vs 26.83h (+/-3.49) (p<0.0001). Conclusion Outpatient DBS surgery does not result in increases in readmissions or emergency visits. This could allow increased availability of DBS surgery during times of medical scarcity and lower the economic barriers to DBS surgery..