Baptist Health South Florida

Baptist Health’s Miami Cancer Institute Study Helps Identify Patients Considered High Risk for Complications Following Surgery for Brain Metastases

November 12, 2021

Research could result in reduced readmissions, improved care and lower costs

MIAMI, FL ― November 12, 2021― Baptist Health’s Miami Cancer Institute researchers have defined factors that make patients more likely to be readmitted to the hospital within 30 days of undergoing surgery for cancer that has spread to the brain. Better awareness of these risk factors could potentially reduce readmissions substantially, both improving patient care and outcomes and lowering healthcare costs.

The results of the study, “Factors Associated with Unplanned Readmissions and Costs Following Resection of Brain Metastases in the United States,” were published today in Nature Scientific Reports, a leading multidisciplinary science journal.

The research team at Miami Cancer Institute was led by senior author Rupesh Kotecha, M.D., chief of Radiosurgery and director of CNS Metastasis at the Institute. More than 200,000 cases of brain metastases are diagnosed in the U.S. each year, and approximately one in six of those who go on to have brain surgery are hospitalized again within 30 days. In addition to prolonging care and patient discomfort, the extrapolated costs associated with the additional hospital days add up to more than $269 million a year nationally. Readmission could also delay further cancer treatment.

“We looked at almost 45,000 surgeries from across the U.S., with about half of all hospitals represented in the data,” Dr. Kotecha said. “Other types of surgeries have seen reduced readmissions in recent years but unplanned readmissions for brain metastases has remained steady. Being able to better predict who has a higher chance of being readmitted could be a game-changer.”

From the study, the Institute team was able to identify the most common high-risk factors. Patients more likely to be readmitted were those with more co-morbidities (particularly those with more than three co-morbidities); longer lengths of stay (especially stays of five days or more); complications such as an infection; patients who were older and male. Having Medicaid and being admitted to a metropolitan teaching hospital also were associated with higher risk. While any cancer can spread to the brain, according to the American Cancer Society, the most common are lung, breast and melanoma.

“The key now is that we need to prevent avoidable readmissions by focusing on this high-risk population,” Dr. Kotecha said. “Depending upon the risk factors, we should consider discharging them to a rehabilitation center rather than home, having clinical staff check in with them more frequently after surgery rather than waiting for the typical follow-up appointment, or even offering other interventions rather than surgery.”

While some risk factors are modifiable, such as post-operative infection, Dr. Kotecha said, others, such as age, are not. Advances in technologies in recent years have given physicians more options when it comes to treating brain cancers, however. For those at extremely high risk, more minimally invasive procedures may be considered, as well as treatments such as radiosurgery, which is targeted radiation. The Institute also offers numerous clinical trials for this patient population with innovative strategies for brain metastasis management.

The next step in advancing the study on readmissions following resection of brain metastases, Dr. Kotecha said, is continued research to verify and further refine the risk stratification model developed by the Institute. Hospitals can then plan strategies to best address those at highest risk.

Find the complete study here.


About Miami Cancer Institute

Miami Cancer Institute brings to South Florida access to personalized clinical treatments and comprehensive support services delivered with unparalleled compassion. No other cancer program in the region has the combination of cancer-fighting expertise and advanced technology—including the first proton therapy center in South Florida, Latin America and the Caribbean, and one of the only radiation oncology programs in the world with each of the newest radiation therapies in one place—to diagnose and deliver precise cancer treatments that achieve the best outcomes and improve the lives of cancer patients. The Institute offers an impressive roster of established community oncologists and renowned experts, clinical researchers and genomic scientists recruited from the nation’s top cancer centers. Selected as Florida’s only member of the Memorial Sloan Kettering Cancer (MSK) Alliance, Miami Cancer Institute is part of a meaningful clinical collaboration that affords patients in South Florida access to innovative treatments and ensures that the standards of care developed by their multidisciplinary disease management teams match those at MSK.

Miami Cancer Institute is part of Baptist Health South Florida, the largest healthcare organization in the region, with 11 hospitals, more than 23,000 employees, 4,000 physicians and 100 outpatient centers, urgent care facilities and physician practices spanning across Miami-Dade, Monroe, Broward and Palm Beach counties. Baptist Health has internationally renowned centers of excellence in cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences. In addition, it includes Baptist Health Medical Group; Baptist Health Quality Network; and Baptist Health Care On Demand, a virtual health platform. A not-for-profit organization supported by philanthropy and committed to its faith-based charitable mission of medical excellence, Baptist Health has been recognized by Fortune as one of the 100 Best Companies to Work For in America and by Ethisphere as one of the World’s Most Ethical Companies. For more information, visit and connect with us on Facebook, Instagram, Twitter and LinkedIn.


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