Neurosurgery Resident McGill University Montreal, Quebec, Canada
Introduction: Post-craniotomy recovery in a neuro-critical care unit (NCCU) has been routine for most patients. There is no evidence to support this practice. To address this, we assessed the development of post-operative adverse events in brain tumor resection patients surveilled in the NCCU or the post-anesthesia care unit (PACU).
Methods: All brain tumor craniotomies performed between 2016-2021 (KP) were reviewed. Inclusion criteria were: age >18; craniotomy for biopsy or resection of intracerebral or extracerebral tumors. Cohorts were divided into two groups based on recovery destination: NCCU or PACU. Past medical history, pre- and post-operative neuroradiological imaging, surgical resection features, and neuropathology results were reviewed for both groups.
Results: There were 681 patients in NCCU group and 397 in the PACU group. Mean ages were 55.6 (NCCU) and 59.7 (PACU) (p < 0.001). The American Society of Anesthesiologists (ASA) class was not significantly different between groups (p=0.89). Median recovery time in the NCCU group was 19 hours, and 4 hours in the PACU group. The incidence of adverse events within 24 hours post-surgery was 0.04 in NCCU group and 0.03 in PACU group (p=0.46). Post-operative hospital stay was 9.5 days in the NCCU group and 8.5 days in PACU group (p < 0.001).
Conclusion : The incidence of adverse events within 24 hours post brain tumor surgery is not different between patients being surveilled for a long period in a NCCU, or a short period in a PACU.
