Postoperative Intensive Care Unit Requirements After Elective Craniotomy
2012; Elsevier BV; Volume: 81; Issue: 1 Linguagem: Inglês
10.1016/j.wneu.2012.11.068
ISSN1878-8769
AutoresBrian W. Hanak, Brian P. Walcott, Brian V. Nahed, Alona Muzikansky, Matthew K. Mian, W. Taylor Kimberly, William T. Curry,
Tópico(s)Airway Management and Intubation Techniques
ResumoObjective-Commonly, patients undergoing craniotomy are admitted to an intensive care setting post-operatively to allow for close monitoring.We aim to determine the frequency with which patients who have undergone elective craniotomies require intensive care unit level interventions or experience significant complications during the post-operative period to identify a subset of patients for whom an alternative to ICU level care may be appropriate. Methods-FollowingInstitutional Review Board approval, a prospective, consecutive cohort of adult patients undergoing elective craniotomy was established at the Massachusetts General Hospital between the dates of April 2010 and March 2011.Inclusion criteria were intradural operations requiring craniotomy performed on adults (18 years of age or greater).Exclusion criteria were cases of an urgent or emergent nature, patients who remained intubated postoperatively, and patients who had a ventriculostomy drain in place at the conclusion of the case.Results-400 patients were analyzed.Univariate analysis revealed that diabetics (p = 0.00047), patients who required intra-operative blood product administration (p = 0.032), older patients (p < 0.0001), patients with higher intra-operative blood losses (p = 0.041), and patients who underwent longer surgical procedures (p = 0.021) were more likely to require ICU-level interventions or experience significant post-operative complications.Multivariate analysis only found diabetes (p =
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