ArticleNeurosurgery2020
Selective Intensive Care Unit Admission After Adult Supratentorial Tumor Craniotomy: Complications, Length of Stay, and Costs.
Article in Neurosurgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Level of evidence of enhanced recovery after surgery (ERAS) strategies for elective craniotomy: An updated systematic review.Neurosurgical review · 2026Pooled it
- Healthcare utilization and 30-day in-hospital costs following brain tumor surgery: A single-center, retrospective cohort study.Neuro-oncology practice · 2026Article
- Review
- Early Postoperative Inflammatory Indices Predict Long-Term Neuro-ICU Stay in Patients Requiring Prolonged Care After Supratentorial Brain Tumor Resection: Development and Validation of an Integrated Model.CNS neuroscience & therapeutics · 2026Article
- In-hospital costs of malignant brain tumor surgery: A systematic review and quality assessment.Neuro-oncology practice · 2026Review
- The changing spectrum of neurointensive care unit needs for tumor patients.Neuro-oncology advances · 2026Review
- Outcome of neurosurgical patients in surgical intensive care unit of a tertiary care center.Pakistan journal of medical sciences · 2026Article
- Article
- Postoperative Surveillance in the Postoperative vs. Intensive Care Unit for Patients Undergoing Elective Supratentorial Brain Tumor Removal: A Retrospective Observational Study.Journal of clinical medicine · 2025Article
- Adverse Events Within 24 hours After 1070 Adult Brain Tumor Surgeries Recovered in a Neurocritical Care Unit or a Postanesthesia Care Unit.Neurosurgery practice · 2025Article
- No ICU Unless 2.0 - Refining ICU admission criteria after elective craniotomy.Brain & spine · 2025Article
- The impact of ondansetron on clinical outcomes in cranial surgery patients: a propensity-matched analysis of retrospective data.Frontiers in aging neuroscience · 2025Article
- Intensive care unit admission criteria: a scoping review.Journal of the Intensive Care Society · 2024Article
- Reduced time to imaging, length of stay, and hospital charges following implementation of a novel postoperative pathway for craniotomy.Journal of neurosurgery · 2023Article
- Association of the classification of intraoperative adverse events (ClassIntra) with complications and neurological outcome after neurosurgical procedures: a prospective cohort study.Acta neurochirurgica · 2023Article
- POST-OPERATIVE INTENSIVE CARE UNIT ADMISSION FOR ELECTIVE BRAIN TUMOUR SURGERIES: A NIGERIAN NEUROSURGICAL UNIT EXPERIENCE.Annals of Ibadan postgraduate medicine · 2023Article
- Routine ICU admission after brain tumor surgery: retrospective validation and critical appraisal of two prediction scores.Acta neurochirurgica · 2023Article
- Routine postoperative admission to the neurocritical intensive care unit after microvascular decompression: necessary or can it be abandoned?Neurosurgical review · 2022Article
- Implementation of the "No ICU - Unless" approach in postoperative neurosurgical management in times of COVID-19.Neurosurgical review · 2022Article
- Reducing the burden of brain tumor surgery.Acta neurochirurgica · 2021Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAdmitting patients to an intensive care or medium care unit (ICU/MCU) after adult supratentorial tumor craniotomy remains common practice even though some studies have suggested lower level care is sufficient for selected patients. We have introduced a "no ICU, unless" policy for tumor craniotomy patients.
objectiveTo provide a quieter postoperative environment for patients, reduce the burden on the ICU department, and to evaluate whether costs can be reduced.
methodsA cohort study was performed comparing patients that underwent tumor craniotomy for supratentorial tumors during 1 yr after introduction (n = 109) of the new policy with the year before (n = 107). Rate of complications was evaluated, as was the length of stay and patient satisfaction using qualitative evaluation. Finally, costs were evaluated comparing the situation before and after implementation of the new protocol.
resultsA reduction in ICU/MCU admittance from 64% to 24% of patients was found resulting in 13.3% cost reduction (€1950 per case), without increasing the length of stay at the ward. The length of stay in the hospital was similar. Complications were significantly reduced after implementing the new policy (0.98 vs 0.53 per patient, P = .003). Patients that were interviewed after the new policy reported feeling safe and at ease at the ward.
conclusionChanging our policy from "ICU, unless" to "no ICU, unless" reduced complication rates and length of stay in the hospital while keeping patients satisfied. Hospital costs related to the admission have been significantly reduced by the new policy.
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