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Updated: Jul 17, 2026
A Craniotomy Surgery Procedure for Chronic Brain Imaging
Published on: February 15, 2008
Factors Influencing Prolonged Intensive Care Unit Length of Stay after Craniotomy for Intracranial Tumor in Children:
Sunisa Sangtongjaraskul1, Surunchana Lerdsirisopon2, Vorrachai Sae-Phua1
1Department of Anesthesiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Department of Anesthesiology, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
Insights
Prolonged intensive care unit (ICU) stays after pediatric brain tumor surgery are linked to longer operative times, endotracheal tubes, and external ventricular drains. Predicting these prolonged ICU stays aids resource management and patient care.
Area of Science:
- Pediatric Neurosurgery
- Critical Care Medicine
- Oncology
Background:
- Postoperative intensive care unit (ICU) admission is standard for pediatric and adult craniotomies.
- This study identifies factors associated with prolonged ICU stays (PIS) after pediatric brain tumor surgery.
Observation:
- A 10-year review of pediatric craniotomies for brain tumors analyzed 314 procedures.
- 37.9% of patients experienced a prolonged ICU stay (more than one day).
Findings:
- Multivariate analysis revealed operative time ≥360 minutes, presence of an endotracheal tube, and external ventricular drain at ICU admission as significant factors for PIS.
- Adjusted odds ratios indicated increased risk with these factors (AORs ranging from 2.438 to 7.469).
Implications:
- Predicting PIS can optimize ICU resource allocation and bed turnover.
- Improved prediction facilitates reduced operation cancellations and better preparation for parental expectations.
- Understanding these factors enhances perioperative planning for pediatric neurosurgery patients.
Background:
Postoperative intensive care unit (ICU) admission is routinely practiced in pediatric and adult craniotomy. This study aims to identify the factors associated with an ICU stay of more than one day (prolonged ICU stay, PIS) after pediatric brain tumor surgery.
Methods:
Medical records of children who underwent craniotomy for brain tumor during a 10-year period were reviewed and analyzed. Perioperative variables were examined and compared between the one-day ICU stay (ODIS) and PIS groups.
Results:
A total of 314 craniotomies performed on 302 patients was included. Patients requiring postoperative ICU care for more than a day represented 37.9% of the sample. Significant factors found in the multivariate analysis affecting prolonged ICU length of stay included operative time ≥360 minutes (adjusted odds ratio [AOR], 2.438; 95% confidence interval [CI]: 1.223-4.861; p = 0.011), presence of an endotracheal (ET) tube (AOR, 7.469; 95% CI: 3.779-14.762; p < 0.001), and external ventricular drain (EVD) at ICU admission (AOR, 2.512; 95% CI: 1.458-4.330; p = 0.001).
Conclusion:
While most children undergoing a craniotomy for brain tumor need a postoperative ICU care of ≤1 day, slightly more than a one-third in our study stayed longer. The prediction of a PIS can be beneficial for optimal resource utilization, increasing ICU bed turnover rate, reduction of operation cancellation, and improved preparation for parent expectations.
How To Cite This Article:
Sangtongjaraskul S, Lerdsirisopon S, Sae-phua V, Kanta S, Kongkiattikul L. Factors Influencing Prolonged Intensive Care Unit Length of Stay after Craniotomy for Intracranial Tumor in Children: A 10-year Analysis from a University Hospital. Indian J Crit Care Med 2023;27(3):205-211.
