Reducing the burden of brain tumor surgery
SourceActa Neurochirurgica, 163, 7, (2021), pp. 1879-1882
Article / Letter to editor
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SubjectRadboudumc 10: Reconstructive and regenerative medicine RIHS: Radboud Institute for Health Sciences; Radboudumc 18: Healthcare improvement science RIHS: Radboud Institute for Health Sciences; Radboudumc 2: Cancer development and immune defence RIMLS: Radboud Institute for Molecular Life Sciences
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.
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