Risk Factors for Complications Following Lateral Skull Base Surgery and the Utility of ICU Monitoring.

Area of Science:

• Neurosurgery
• Otolaryngology
• Critical Care Medicine

Background:

• Vestibular schwannoma resection via lateral skull base surgery requires careful postoperative management.
• Understanding factors predicting intensive care unit (ICU) admission is crucial for resource allocation and patient care optimization.

Purpose of the Study:

• To evaluate the necessity of ICU management post-lateral skull base surgery for vestibular schwannoma.
• To identify independent risk factors associated with ICU complications.

Main Methods:

• Retrospective review of 200 consecutive patients undergoing lateral skull base surgery for vestibular schwannoma.
• Analysis of patient and treatment factors to identify predictors of ICU complications using multivariate logistic regression.

Main Results:

• 8.5% of patients required ICU admission, with hypertensive urgency being the most common complication.
• Preoperative hypertension (aOR 5.43) and large tumor volume (aOR 3.29) were independently associated with increased ICU complication risk.
• Obesity and other comorbidities did not independently predict ICU admission.

Conclusions:

• ICU admission following vestibular schwannoma surgery is infrequent, with hypertensive urgency being the primary concern.
• Preoperative hypertension and tumor volume >4500 mm³ are significant predictors of ICU complications.
• Findings suggest potential for risk stratification to identify patients suitable for stepdown unit care, warranting further prospective validation.