Published in:
Open Access
01-07-2021 | Craniotomy | Original Article - Tumor - Other
Reducing the burden of brain tumor surgery
Authors:
Mark ter Laan, Suzanne Roelofs, Eddy M. M. Adang, Ronald H. M. A. Bartels
Published in:
Acta Neurochirurgica
|
Issue 7/2021
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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.