Can patients safely be admitted to a ward after craniotomy for resection of intra-axial brain tumors?

Farhan A. Mirza, Catherine Wang, Thomas Pittman

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Objective: We reviewed the safety of our practice of admitting patients who have undergone a craniotomy for resection of an intra-axial brain tumor to a floor bed instead of an ICU. We also tried to quantify the risk that patients electively admitted to the ICU would develop a problem that could not have been effectively managed on the ward. Methods: A retrospective chart review was performed of both adult and pediatric patients who underwent craniotomy by the senior author for resection of an intra-axial brain tumor between January 2012 and December 2015. 413 patient charts were reviewed; 16 patients were omitted due to incomplete records. Results: Four hundred twenty-one craniotomies (393 supratentorial, 28 infratentorial) were performed in 397 patients, 35 of whom were <18 years of age. Three hundred fifty-five patients (83%) were admitted to floor beds; 4 (1.1%) developed complications that required transfer to an ICU. None of the 4 died or had lasting disability. Sixty-six patients, 51 adults and 15 children, were admitted to the ICU after their operation. Twenty-five of these patients had an absolute indication for ICU admission: 9 required a ventilator, 14 had an EVD and 2 were medically unstable. Of the remaining 41, none developed a complication that would have required transfer to an ICU had they been on the ward. Conclusion: It is safe to admit almost all patients to a floor bed after craniotomy for intra-axial brain tumor resection. The risk of a catastrophic problem occurring after a 4 hour stay in the post anesthesia care unit is extremely low. Furthermore, even patients who are electively managed in an ICU are unlikely to develop problems that would lead to a worse outcome had they been in a floor bed.

Original languageEnglish
Pages (from-to)201-205
Number of pages5
JournalBritish Journal of Neurosurgery
Volume32
Issue number2
DOIs
StatePublished - Mar 4 2018

Bibliographical note

Publisher Copyright:
© 2017, © 2017 The Neurosurgical Foundation.

Keywords

  • Craniotomy
  • brain neoplasm
  • economics
  • intracranial tumor
  • post-operative period
  • resource utilization

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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