Prevalence of post-operative complications after craniotomy surgery, a tertiary hospital study, Saudi Arabia

Neurosurgery is the high-risk specialty due to the complexity of the brain and the potential for serious complications. Craniotomy often requires intensive care unit admission, as postoperative issues like infections, bleeding, and neurological complications are common. These complications can increase mortality and prolong hospitalization. This study aims to determine the prevalence and causes of post-craniotomy complications and propose strategies for prevention.

A retrospective study was conducted at the National Guard Health Affairs Hospital in Riyadh using consecutive non-probability sampling. Data were collected via chart review for all patients, who met the inclusion criteria, which were any patient who underwent Craniotomy, regardless of american society of anesthesiologists (ASA), sex, pre-operative diagnosis, and comorbidities. Data was cleaned in Excel and analyzed via international business machines corporation (IBM) SPSS 29.0.0.

Our study included 797 craniotomy patients, with males comprising the majority (461, 57.8%) and a mean age of 47.2 years. Postoperative complications were reported in 186 patients (23.3%). The most frequent complications were infection and hemodynamic instability (each 70, 37.6%), followed by death (30, 16.1%), and seizures (26, 14.0%). Brain tumors were the most common diagnosis (284, 35.6%). Head trauma (96, 12.0%) and hemorrhagic conditions showed significantly higher complication rates; subdural hemorrhage (P = 0.014), stroke (P = 0.011), intracerebral hemorrhage (P = 0.001), and head trauma (P < 0.001). Complications significantly prolonged hospital stays (mean 12.13 vs. 3.73 days; P < 0.001). Males had longer stayed than females (P < 0.001), and younger patients (≤30 years) had the longest length of stay (LOS) (P < 0.001). Finally, there is no comorbidity-related predictor of LOS among patients in the regression analysis.

In Conclusion, complications in craniotomy can cause a significant burden on the health sector financially, and on the patient emotionally. Future prevention strategies from the surgical team to avoid such a condition should be thought of and implemented after pointing out the areas that can be improved. With our study, we hope that we shed some light on some of the common types of complications to aid in the search for a better understanding of such problem.