{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T11:19:05Z","timestamp":1766747945265,"version":"3.40.5"},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,7,23]],"date-time":"2023-07-23T00:00:00Z","timestamp":1690070400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Readmissions are major healthcare expenditures, key hospital metrics, and are often preceded by an evaluation in the emergency department (ED). The purpose of this study was to analyze ED visits within 30 days of endoscopic skull base surgery (ESBS), risk factors for readmission once in the ED, and ED\u2010related evaluation and outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective review from January 2017 to December 2022 at a high\u2010volume center of all ESBS patients who presented to the ED within 30 days of surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 593 ESBS cases, 104 patients (17.5%) presented to the ED following surgery within 30 days, with a median presentation of 6 days post\u2010discharge (IQR 5\u201314); 54 (51.9%) patients were discharged while 50 (48.1%) were readmitted. Readmitted patients were significantly older than discharged patients (median 60 years, IQR 50\u201368\u00a0vs. 48 years, 33\u201356; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01). Extent of ESBS was not associated with readmission or discharge from the ED. The most common discharge diagnoses were headache (<jats:italic>n<\/jats:italic>\u00a0=\u00a013, 24.1%) and epistaxis (<jats:italic>n<\/jats:italic>\u00a0=\u00a010, 18.5%); the most common readmitting diagnoses were serum abnormality (<jats:italic>n<\/jats:italic>\u00a0=\u00a015, 30.0%) and altered mental status (<jats:italic>n<\/jats:italic>\u00a0=\u00a05, 10.0%). Readmitted patients underwent significantly more laboratory testing than discharged patients (median 6, IQR 3\u20139\u00a0vs. 4, 1\u20136; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Approximately half of patients who presented to the ED following ESBS were discharged home but underwent significant workup. Follow\u2010up within 7 days of discharge, risk\u2010stratified endocrine care pathways, and efforts to address the social determinants of health may be considered to optimize postoperative ESBS care.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.23237","type":"journal-article","created":{"date-parts":[[2023,7,9]],"date-time":"2023-07-09T11:14:15Z","timestamp":1688901255000},"page":"613-620","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Emergency department visits following endoscopic skull base surgery: An opportunity for improvement"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6217-8451","authenticated-orcid":false,"given":"Neal R.","family":"Godse","sequence":"first","affiliation":[{"name":"Section of Rhinology and Skull Base Surgery Head and Neck Institute Cleveland Clinic Foundation Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jakub","family":"Jarmula","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery Cleveland Clinic Lerner College of Medicine of Case Western Reserve University Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Varun R.","family":"Kshettry","sequence":"additional","affiliation":[{"name":"Section of Rhinology and Skull Base Surgery Head and Neck Institute Cleveland Clinic Foundation Cleveland Ohio USA"},{"name":"Department of Neurological Surgery Cleveland Clinic Lerner College of Medicine of Case Western Reserve University Cleveland Ohio USA"},{"name":"Section of Skull Base Surgery Rose Ella Burkhardt Brain Tumor and Neuro\u2010Oncology Center Neurological Institute Cleveland Clinic Foundation Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Troy D.","family":"Woodard","sequence":"additional","affiliation":[{"name":"Section of Rhinology and Skull Base Surgery Head and Neck Institute Cleveland Clinic Foundation Cleveland Ohio USA"},{"name":"Department of Neurological Surgery Cleveland Clinic Lerner College of Medicine of Case Western Reserve University Cleveland Ohio USA"},{"name":"Section of Skull Base Surgery Rose Ella Burkhardt Brain Tumor and Neuro\u2010Oncology Center Neurological Institute Cleveland Clinic Foundation Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pablo F.","family":"Recinos","sequence":"additional","affiliation":[{"name":"Section of Rhinology and Skull Base Surgery Head and Neck Institute Cleveland Clinic Foundation Cleveland Ohio USA"},{"name":"Department of Neurological Surgery Cleveland Clinic Lerner College of Medicine of Case Western Reserve University Cleveland Ohio USA"},{"name":"Section of Skull Base Surgery Rose Ella Burkhardt Brain Tumor and Neuro\u2010Oncology Center Neurological Institute Cleveland Clinic Foundation Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raj","family":"Sindwani","sequence":"additional","affiliation":[{"name":"Section of Rhinology and Skull Base Surgery Head and Neck Institute Cleveland Clinic Foundation Cleveland Ohio USA"},{"name":"Department of Neurological Surgery Cleveland Clinic Lerner College of Medicine of Case Western Reserve University Cleveland Ohio USA"},{"name":"Section of Skull Base Surgery Rose Ella Burkhardt Brain Tumor and Neuro\u2010Oncology Center Neurological Institute Cleveland Clinic Foundation Cleveland Ohio 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