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Awake Craniotomy Program Implementation.

Diogo Moniz-Garcia1, Elird Bojaxhi2, Bijan J Borah3,4

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Summary
This summary is machine-generated.

Standardizing awake craniotomy procedures reduced hospital stay, intensive care unit (ICU) time, and costs without impacting patient outcomes. This optimized protocol proved cost-effective and improved safety for complex brain tumor surgeries.

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Area of Science:

  • Neurosurgery
  • Health Economics
  • Healthcare Management

Background:

  • Implementing multidisciplinary teams for complex brain tumor surgeries requiring awake craniotomies incurs significant costs.
  • There is limited analysis on the cost-utility of standardized multidisciplinary teams for awake craniotomies.

Purpose of the Study:

  • To assess the cost utility of introducing a standardized program for awake craniotomies.

Main Methods:

  • A retrospective economic evaluation was conducted comparing awake craniotomies before (2016-2018) and after (2018-2021) standardization.
  • Direct medical costs and 1-year mortality were analyzed from a healthcare institution's perspective.
  • Patient outcomes including length of stay, ICU admission, resection extent, readmission rates, and mortality were compared.

Main Results:

  • Standardization reduced mean length of stay (3.34 to 2.46 days) and ICU stay (1.32 to 0.99 nights).
  • The 30-day readmission rate decreased from 14% to 5%.
  • The standardized protocol resulted in mean cost savings of $7088.80 and decreased 1-year mortality, proving to be a dominant intervention.

Conclusions:

  • Standardization of awake craniotomy protocols led to reduced length of stay, ICU time, and direct medical costs.
  • These improvements were achieved without compromising patient outcomes, resection extent, or complication rates.
  • The optimized protocol demonstrated cost savings and reduced readmissions, highlighting its clinical and economic benefits.