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. 2021 Jul;163(7):1879-1882.
doi: 10.1007/s00701-020-04543-y. Epub 2020 Sep 1.

Reducing the burden of brain tumor surgery

Mark Ter Laan  1 , Suzanne Roelofs  2 , Eddy M M Adang  3 , Ronald H M A Bartels  4
Affiliations

Reducing the burden of brain tumor surgery

Mark Ter Laan et al. Acta Neurochir (Wien). 2021 Jul.

Abstract

Background: Even though the need has been challenged, admitting patients to an intensive care or medium care unit (ICU/MCU) after adult supratentorial tumor craniotomy remains common practice. We have introduced a "no ICU, unless" policy for tumor craniotomy patients and evaluate costs, complications, and length of stay.

Methods: A prospective cohort study was performed comparing patients that underwent tumor craniotomy for supratentorial tumors during 2 years after introduction of the new policy with the year before.

Results: A reduction in ICU/MCU admittance from 88 to 23% of patients was found resulting in 13% cost reduction. Also, the new policy resulted in a 1.4-day shorter post-operative length of stay. Minor complications were reduced, while major complications remained the same. All major complications are reviewed.

Conclusions: We show that routine post-operative ICU/MCU admittance after tumor craniotomy does not reduce complications, but actually interferes with recovery of our patients. Changing the paradigm results in earlier discharge and cost reduction.

Keywords: Brain tumor; Health care costs; Neurosurgery; Post-operative care.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

References

    1. Au K, Bharadwaj S, Venkatraghavan L, Bernstein M. Outpatient brain tumor craniotomy under general anesthesia. J Neurosurg. 2016;125:1130–1135. doi: 10.3171/2015.11.JNS152151. - DOI - PubMed
    1. Beauregard CL, Friedman WA. Routine use of postoperative ICU care for elective craniotomy: a cost-benefit analysis. Surg Neurol. 2003;60:483–489. doi: 10.1016/S0090-3019(03)00517-2. - DOI - PubMed
    1. Bui JQ, Mendis RL, van Gelder JM, Sheridan MM, Wright KM, Jaeger M. Is postoperative intensive care unit admission a prerequisite for elective craniotomy? J Neurosurg. 2011;115:1236–1241. doi: 10.3171/2011.8.JNS11105. - DOI - PubMed
    1. de Almeida CC, Boone MD, Laviv Y, Kasper BS, Chen CC, Kasper EM. The utility of routine intensive care admission for patients undergoing intracranial neurosurgical procedures: a systematic review. Neurocrit Care. 2018;28:35–42. doi: 10.1007/s12028-017-0433-4. - DOI - PubMed
    1. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–213. doi: 10.1097/01.sla.0000133083.54934.ae. - DOI - PMC - PubMed

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