Objective: To characterize sex-based differences in perioperative risk factors and early postoperative outcomes in Deep Brain Stimulation (DBS) for Parkinson’s disease (PD) using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) dataset.

Background: Despite DBS being a well-established intervention for PD, large-scale analyses of sex-based perioperative risks and postoperative outcomes remain limited. Identifying these differences may improve risk stratification, optimize patient selection, and inform perioperative management strategies.

Method: We analyzed ACS-NSQIP data from 2010 to 2020. Patients who underwent DBS implantation were identified using CPT codes. Demographic, preoperative, and operative variables were compared between males and females. Postoperative complications, discharge outcomes, and readmissions (2012–2020) were analyzed. Logistic regression models identified predictors of adverse outcomes, adjusting for relevant covariates.

Results: Among 6,326 patients, males (59.5%) were older at surgery than females (p<0.001). Hypertension was more prevalent in females (p=0.001), while diabetes was more common in males (p=0.007). Pulmonary embolism was significantly more frequent in males (p<0.05), though other systemic and wound-related complications were comparable across sexes. Advanced age and higher ASA classification were associated with non-home discharge in both sexes, with a stronger effect in females (OR: 5.69 vs. 1.91, p<0.001). Smoking increased complication risk in both males (OR: 2.11, p=0.032) and females (OR: 2.63, p=0.023), while diabetes was associated with lower readmissions in males (OR: 0.35, p=0.007).

Conclusion: This study highlights significant sex-based differences in perioperative risks and postoperative outcomes following DBS for PD. While overall complication rates were low, males had a higher risk of pulmonary embolism, while females had greater odds of non-home discharge. Smoking was a strong predictor of complications in both sexes, while diabetes appeared protective against readmissions in males. These findings underscore the need for sex-specific perioperative management strategies and further research to optimize risk stratification and postoperative care, which may help reduce hospital readmissions and overall healthcare costs.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/sex-based-differences-in-perioperative-risks-and-outcomes-in-deep-brain-stimulation-for-parkinsons-disease-a-decade-long-acs-nsqip-analysis/