Short-term 30-day adverse events following awake versus asleep deep brain stimulation for movement disorders: a nationwide registry-based study
Introduction: Deep Brain Stimulation (DBS) is FDA-approved for the management of medically refractory movement disorders and epilepsy. We aim to assess potential differences in adverse eventsamong patients undergoing asleep versus awake DBS, to facilitate a patient centric decision-making process fo...
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Elsevier
2025-01-01
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| Series: | Brain and Spine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772529425002127 |
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| author | Victor Gabriel El-Hajj Ryan Nguyen Abdul Karim Ghaith Victor E. Staartjes Christian Möhrlen Adrian Elmi-Terander Rushna Ali |
| author_facet | Victor Gabriel El-Hajj Ryan Nguyen Abdul Karim Ghaith Victor E. Staartjes Christian Möhrlen Adrian Elmi-Terander Rushna Ali |
| author_sort | Victor Gabriel El-Hajj |
| collection | DOAJ |
| description | Introduction: Deep Brain Stimulation (DBS) is FDA-approved for the management of medically refractory movement disorders and epilepsy. We aim to assess potential differences in adverse eventsamong patients undergoing asleep versus awake DBS, to facilitate a patient centric decision-making process for the selection of ideal anesthesia modality for individuals undergoing DBS procedures. Methods: The ACS National Surgical Quality Improvement Program (NSQIP) database was queried for all patients undergoing DBS treatment between 2011 and 2020 in patients with a diagnosis of Parkinson's Disease, and Essential Tremor. Propensity score matching in a 2:1 ratio was performed. The primary endpoint was to quantify any short-term adverse events. Results: In total, 1778 patients undergoing asleep (75.7 %) and awake DBS procedures (24.3 %) were identified. The median age among included was 68.0 with most being males (65 %). After 2:1 propensity score matching there was no remaining baseline difference. 30-day complication rates were comparable between groups (2.3 % asleep vs. 0.7 % awake; p = 0.062). Similarly, there were no significant differences in 30-day readmission (3.5 % vs. 3.5 %; p = 0.96), reoperation (1.4 % vs. 0.9 %; p = 0.48), or non-home discharge (3.5 % vs. 3.0 %; p = 0.63). Median hospital length of stay did not differ significantly (0 vs. 0 days; p = 0.23). Conclusion: In this matched analysis using data from a prospective multicenter database of U.S. hospitals, asleep and awake DBS demonstrated comparable 30-day outcomes. No significant differences were observed in complication rates, readmissions, reoperations, discharge disposition, or length of hospital stay. These findings support clinical equipoise between the two approaches and underscore the importance of tailoring the choice of technique to individual patient characteristics and preferences. |
| format | Article |
| id | doaj-art-619f042c274c4152b000af2d9bc98565 |
| institution | Kabale University |
| issn | 2772-5294 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brain and Spine |
| spelling | doaj-art-619f042c274c4152b000af2d9bc985652025-08-20T05:08:16ZengElsevierBrain and Spine2772-52942025-01-01510439310.1016/j.bas.2025.104393Short-term 30-day adverse events following awake versus asleep deep brain stimulation for movement disorders: a nationwide registry-based studyVictor Gabriel El-Hajj0Ryan Nguyen1Abdul Karim Ghaith2Victor E. Staartjes3Christian Möhrlen4Adrian Elmi-Terander5Rushna Ali6Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SwedenDepartment of Neurological Surgery, Mayo Clinic, Rochester, MN, USADepartment of Neurological Surgery, Johns Hopkins University, Baltimore, MD, USAMachine Intelligence in Clinical Neuroscience & Microsurgical Neuroanatomy (MICN) Laboratory, Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandDepartment of Anesthesiology and Perioperative Care, University Hospital Zurich, Zurich, SwitzerlandDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Corresponding author. Capio Spine Center Stockholm, Löwenströmska Hospital, Box 2074, Upplands-Väsby, 194 02, Sweden.Department of Neurological Surgery, Mayo Clinic, Rochester, MN, USAIntroduction: Deep Brain Stimulation (DBS) is FDA-approved for the management of medically refractory movement disorders and epilepsy. We aim to assess potential differences in adverse eventsamong patients undergoing asleep versus awake DBS, to facilitate a patient centric decision-making process for the selection of ideal anesthesia modality for individuals undergoing DBS procedures. Methods: The ACS National Surgical Quality Improvement Program (NSQIP) database was queried for all patients undergoing DBS treatment between 2011 and 2020 in patients with a diagnosis of Parkinson's Disease, and Essential Tremor. Propensity score matching in a 2:1 ratio was performed. The primary endpoint was to quantify any short-term adverse events. Results: In total, 1778 patients undergoing asleep (75.7 %) and awake DBS procedures (24.3 %) were identified. The median age among included was 68.0 with most being males (65 %). After 2:1 propensity score matching there was no remaining baseline difference. 30-day complication rates were comparable between groups (2.3 % asleep vs. 0.7 % awake; p = 0.062). Similarly, there were no significant differences in 30-day readmission (3.5 % vs. 3.5 %; p = 0.96), reoperation (1.4 % vs. 0.9 %; p = 0.48), or non-home discharge (3.5 % vs. 3.0 %; p = 0.63). Median hospital length of stay did not differ significantly (0 vs. 0 days; p = 0.23). Conclusion: In this matched analysis using data from a prospective multicenter database of U.S. hospitals, asleep and awake DBS demonstrated comparable 30-day outcomes. No significant differences were observed in complication rates, readmissions, reoperations, discharge disposition, or length of hospital stay. These findings support clinical equipoise between the two approaches and underscore the importance of tailoring the choice of technique to individual patient characteristics and preferences.http://www.sciencedirect.com/science/article/pii/S2772529425002127Deep brain stimulationAwakeAsleepGeneral anesthesiaLocal anesthesia |
| spellingShingle | Victor Gabriel El-Hajj Ryan Nguyen Abdul Karim Ghaith Victor E. Staartjes Christian Möhrlen Adrian Elmi-Terander Rushna Ali Short-term 30-day adverse events following awake versus asleep deep brain stimulation for movement disorders: a nationwide registry-based study Brain and Spine Deep brain stimulation Awake Asleep General anesthesia Local anesthesia |
| title | Short-term 30-day adverse events following awake versus asleep deep brain stimulation for movement disorders: a nationwide registry-based study |
| title_full | Short-term 30-day adverse events following awake versus asleep deep brain stimulation for movement disorders: a nationwide registry-based study |
| title_fullStr | Short-term 30-day adverse events following awake versus asleep deep brain stimulation for movement disorders: a nationwide registry-based study |
| title_full_unstemmed | Short-term 30-day adverse events following awake versus asleep deep brain stimulation for movement disorders: a nationwide registry-based study |
| title_short | Short-term 30-day adverse events following awake versus asleep deep brain stimulation for movement disorders: a nationwide registry-based study |
| title_sort | short term 30 day adverse events following awake versus asleep deep brain stimulation for movement disorders a nationwide registry based study |
| topic | Deep brain stimulation Awake Asleep General anesthesia Local anesthesia |
| url | http://www.sciencedirect.com/science/article/pii/S2772529425002127 |
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