Readmissions after CNS tumor surgery and associations with social determinants of health.

Abstract

e14040 Background: Socioeconomic status (SES) and social determinants of health (SDOH) may impact outcomes in patients with central nervous system (CNS) tumors. Prior studies suggest public or absence of insurance coverage, neighborhood-level deprivation, and structural inequities are associated with higher 30- and 90-day hospital readmission rates following craniotomy and tumor-directed neurosurgical care. This study evaluated the association between SES and SDOH-related factors and unplanned readmissions among adults undergoing surgery for primary CNS tumors at an urban, tertiary-care hospital. Methods: This retrospective cohort study assessed adult patients with primary CNS tumors who underwent craniotomy or biopsy between 01-2023 and 12-2024. Patient demographics, tumor characteristics, insurance status, and neighborhood-level socioeconomic data were abstracted from an institutional registry. Unplanned readmissions within 30 and 90 days of discharge were identified. Neighborhood SES was estimated using ZIP code–level poverty data from the U.S. Census. Descriptive and inferential statistical analyses compared readmission patterns across demographic, clinical, and SES variables. Results: Among 233 patients, 132 (56.7%) were female; the median age was 60 years (range, 18–85). 34 patients (14.6%) experienced unplanned readmissions within 30 days, and 55 (23.6%) within 90 days. Readmissions were more frequent in patients with malignant tumors. Tumor histology demonstrated a statistically significant association with readmission (p=0.033); glioblastoma accounted for most 90-day readmissions (31/55; 54.4%) and had the highest tumor-specific readmission rate (34.4%) relative to meningioma (17.5%) or pituitary adenoma (8.7%). Male patients showed a trend toward higher readmission rates than female patients (28.7% vs. 19.7%; p = 0.12). No statistically significant associations were noted between readmission and insurance status, payer class, or race/ethnicity, likely reflecting limited statistical power and small subgroup sizes. Conclusions: Approximately 24% of patients with primary CNS tumors experienced unplanned readmission within 90 days of surgery. Tumor biology, particularly malignant tumors like glioblastoma, was the strongest risk factor for readmission in this cohort. Sex-based differences demonstrated a trend toward higher readmission among male patients. SES- and SDOH-related factors showed no significant association. This study supports the role of tumor invasiveness as a key driver of postoperative readmissions and highlights the need for larger, multi-institutional studies to evaluate the impact of SDOH on and strategies to mitigate unplanned readmissions.