Adverse Events Within 24 hours After 1070 Adult Brain Tumor Surgeries Recovered in a Neurocritical Care Unit or a...

By convention, patients who have undergone a craniotomy for tumor are monitored in a neurocritical care unit (NCCU) overnight, yet there is little evidence to justify the need for such intense care. Here, we compared postoperative adverse events in patients after brain tumor surgeries surveilled in a NCCU overnight or postanesthesia care unit (PACU) for a shorter duration.

We retrospectively studied 1070 consecutive patients who underwent craniotomy for brain tumor between 2016 and 2021. Inclusion criteria were age ≥18 years and craniotomy for resection or biopsy of intracerebral or extracerebral tumors. Cohorts were divided into 2 groups based on recovery destination, NCCU or PACU. Medical history, preoperative and postoperative neuroimaging, surgical resection features, diagnosis, and postoperative adverse events within 24 hours were reviewed for all patients.

A total of 674 patients in the NCCU group and 396 patients in the PACU group were studied. The mean ages were 55.7 (NCCU) and 59.6 (PACU) years (P < .001). The American Society of Anesthesiologists class was not significantly different between groups (P = .42). The median recovery time was 19 hours (SD 24.5) for the NCCU group and 4 hours (SD 8) for the PACU group (P < .001). The incidence of adverse events within 24 hours postsurgery was 0.04 for the NCCU group and 0.028 for the PACU group (odds ratio 0.69, 95% CI 0.32-1.38, P = .40). The mean postoperative hospital stay was 9.6 days (SD 15.6) for the NCCU group and 8.5 days (SD 17.5) for the PACU group (P < .001).

The incidence of adverse events within 24 hours after brain tumor surgery was not different between patients being surveilled for a long period in a NCCU or for a short period in a PACU.