Postoperative Care Pathway to Reduce Readmissions following Endoscopic Pituitary Surgery

Objective: Readmission rates are an important indicator of healthcare quality. 30-day hospital readmission following endoscopic transsphenoidal pituitary surgery (ETPS) occur in up to 14% of patients. Our prior retrospective review found 13.9% of patients were readmitted within 30 days at a single tertiary referral center. Delayed hyponatremia was the most common cause of readmission (4.2%), accounting for 29.8% of all readmissions. Sodium levels reached a nadir between postoperative days 5 to 7. This correlated to patients with delayed hyponatremia being readmitted significantly earlier than other causes. Furthermore, readmitted patients had significantly less outpatient follow-up with endocrinology. Postoperative outpatient follow-up with endocrinology was found to be protective against readmission. Our goal was to develop a multidisciplinary postoperative care pathway: (1) to reduce 30-day hospital readmissions following ETPS; (2) improve quality of patient care; and (3) improve coordination of care with endocrinology.