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Optimizing post anesthesia care unit admission after elective craniotomy for brain tumors: a cohort study

Background Postoperative admission to intensive care unit (ICU) after craniotomy for brain tumor was the routine in the past years. However, there is little evidence supporting this dogma and doubts have been casted by many authors in the last years. Our aim was to identify risk factors for ICU admi... Full description

Journal Title: Acta neurochirurgica 2021-01-31, Vol.164 (3), p.635-641
Main Author: Munari, Marina
Other Authors: De Cassai, Alessandro , Sandei, Ludovica , Correale, Christelle , Calandra, Sabrina , Iori, Davide , Geraldini, Federico , Vitalba, Alessandra , Grandis, Marzia , Chioffi, Franco , Navalesi, Paolo
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: Vienna: Springer Vienna
ID: ISSN: 0001-6268
Link: https://www.ncbi.nlm.nih.gov/pubmed/33517465
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title: Optimizing post anesthesia care unit admission after elective craniotomy for brain tumors: a cohort study
format: Article
creator:
  • Munari, Marina
  • De Cassai, Alessandro
  • Sandei, Ludovica
  • Correale, Christelle
  • Calandra, Sabrina
  • Iori, Davide
  • Geraldini, Federico
  • Vitalba, Alessandra
  • Grandis, Marzia
  • Chioffi, Franco
  • Navalesi, Paolo
subjects:
  • Anesthesia
  • Brain cancer
  • Brain Neoplasms - surgery
  • Brain tumors
  • Cohort Studies
  • Craniotomy - adverse effects
  • Elective Surgical Procedures - adverse effects
  • Humans
  • Intensive Care Units
  • Interventional Radiology
  • Medicine
  • Medicine & Public Health
  • Minimally Invasive Surgery
  • Neurology
  • Neuroradiology
  • Neurosurgery
  • Original Article - Brain Tumors
  • Patients
  • Postoperative Complications - etiology
  • Prospective Studies
  • Retrospective Studies
  • Risk factors
  • Sensitivity analysis
  • Surgery
  • Surgical Orthopedics
ispartof: Acta neurochirurgica, 2021-01-31, Vol.164 (3), p.635-641
description: Background Postoperative admission to intensive care unit (ICU) after craniotomy for brain tumor was the routine in the past years. However, there is little evidence supporting this dogma and doubts have been casted by many authors in the last years. Our aim was to identify risk factors for ICU admission after elective brain tumor surgery in order to propose an individualized admission to ICU tailored on patient needs. Methods We conducted a retrospective cohort study including all patients undergoing elective surgery for brain tumor in a neurosurgical post anesthesia care unit of a university hospital over a period of 6 years. In order to identify and validate risk factors for ICU admission, we split the final cohort of patients in a training cohort (two/third of the cohort) and the validation cohort (one/third of the cohort) using a random sequence. Using univariate and multivariate logistic regression, we created a scoring system in the training cohort and tested it with the validation cohort. Moreover, we perform a sensitivity analysis on the overall population. Results A total of 420 patients were eligible for this study. ASA-PS, tumor volume, and surgery length entered the scoring system. Sensitivity analysis on the overall population for the scoring system had an AUC of 0.774 (95% CI 0.668–0.880, the best threshold at 12.5) Conclusions We created a tool based on ASA-PS, length of surgery, and tumor volume to evaluate the risk for ICU admission after supratentorial tumor resection. Prospective studies are deemed necessary to validate our tool.
language: eng
source:
identifier: ISSN: 0001-6268
fulltext: no_fulltext
issn:
  • 0001-6268
  • 0942-0940
url: Link


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titleOptimizing post anesthesia care unit admission after elective craniotomy for brain tumors: a cohort study
creatorMunari, Marina ; De Cassai, Alessandro ; Sandei, Ludovica ; Correale, Christelle ; Calandra, Sabrina ; Iori, Davide ; Geraldini, Federico ; Vitalba, Alessandra ; Grandis, Marzia ; Chioffi, Franco ; Navalesi, Paolo
creatorcontribMunari, Marina ; De Cassai, Alessandro ; Sandei, Ludovica ; Correale, Christelle ; Calandra, Sabrina ; Iori, Davide ; Geraldini, Federico ; Vitalba, Alessandra ; Grandis, Marzia ; Chioffi, Franco ; Navalesi, Paolo
descriptionBackground Postoperative admission to intensive care unit (ICU) after craniotomy for brain tumor was the routine in the past years. However, there is little evidence supporting this dogma and doubts have been casted by many authors in the last years. Our aim was to identify risk factors for ICU admission after elective brain tumor surgery in order to propose an individualized admission to ICU tailored on patient needs. Methods We conducted a retrospective cohort study including all patients undergoing elective surgery for brain tumor in a neurosurgical post anesthesia care unit of a university hospital over a period of 6 years. In order to identify and validate risk factors for ICU admission, we split the final cohort of patients in a training cohort (two/third of the cohort) and the validation cohort (one/third of the cohort) using a random sequence. Using univariate and multivariate logistic regression, we created a scoring system in the training cohort and tested it with the validation cohort. Moreover, we perform a sensitivity analysis on the overall population. Results A total of 420 patients were eligible for this study. ASA-PS, tumor volume, and surgery length entered the scoring system. Sensitivity analysis on the overall population for the scoring system had an AUC of 0.774 (95% CI 0.668–0.880, the best threshold at 12.5) Conclusions We created a tool based on ASA-PS, length of surgery, and tumor volume to evaluate the risk for ICU admission after supratentorial tumor resection. Prospective studies are deemed necessary to validate our tool.
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subjectAnesthesia ; Brain cancer ; Brain Neoplasms - surgery ; Brain tumors ; Cohort Studies ; Craniotomy - adverse effects ; Elective Surgical Procedures - adverse effects ; Humans ; Intensive Care Units ; Interventional Radiology ; Medicine ; Medicine & Public Health ; Minimally Invasive Surgery ; Neurology ; Neuroradiology ; Neurosurgery ; Original Article - Brain Tumors ; Patients ; Postoperative Complications - etiology ; Prospective Studies ; Retrospective Studies ; Risk factors ; Sensitivity analysis ; Surgery ; Surgical Orthopedics
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descriptionBackground Postoperative admission to intensive care unit (ICU) after craniotomy for brain tumor was the routine in the past years. However, there is little evidence supporting this dogma and doubts have been casted by many authors in the last years. Our aim was to identify risk factors for ICU admission after elective brain tumor surgery in order to propose an individualized admission to ICU tailored on patient needs. Methods We conducted a retrospective cohort study including all patients undergoing elective surgery for brain tumor in a neurosurgical post anesthesia care unit of a university hospital over a period of 6 years. In order to identify and validate risk factors for ICU admission, we split the final cohort of patients in a training cohort (two/third of the cohort) and the validation cohort (one/third of the cohort) using a random sequence. Using univariate and multivariate logistic regression, we created a scoring system in the training cohort and tested it with the validation cohort. Moreover, we perform a sensitivity analysis on the overall population. Results A total of 420 patients were eligible for this study. ASA-PS, tumor volume, and surgery length entered the scoring system. Sensitivity analysis on the overall population for the scoring system had an AUC of 0.774 (95% CI 0.668–0.880, the best threshold at 12.5) Conclusions We created a tool based on ASA-PS, length of surgery, and tumor volume to evaluate the risk for ICU admission after supratentorial tumor resection. Prospective studies are deemed necessary to validate our tool.
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titleOptimizing post anesthesia care unit admission after elective craniotomy for brain tumors: a cohort study
authorMunari, Marina ; De Cassai, Alessandro ; Sandei, Ludovica ; Correale, Christelle ; Calandra, Sabrina ; Iori, Davide ; Geraldini, Federico ; Vitalba, Alessandra ; Grandis, Marzia ; Chioffi, Franco ; Navalesi, Paolo
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abstractBackground Postoperative admission to intensive care unit (ICU) after craniotomy for brain tumor was the routine in the past years. However, there is little evidence supporting this dogma and doubts have been casted by many authors in the last years. Our aim was to identify risk factors for ICU admission after elective brain tumor surgery in order to propose an individualized admission to ICU tailored on patient needs. Methods We conducted a retrospective cohort study including all patients undergoing elective surgery for brain tumor in a neurosurgical post anesthesia care unit of a university hospital over a period of 6 years. In order to identify and validate risk factors for ICU admission, we split the final cohort of patients in a training cohort (two/third of the cohort) and the validation cohort (one/third of the cohort) using a random sequence. Using univariate and multivariate logistic regression, we created a scoring system in the training cohort and tested it with the validation cohort. Moreover, we perform a sensitivity analysis on the overall population. Results A total of 420 patients were eligible for this study. ASA-PS, tumor volume, and surgery length entered the scoring system. Sensitivity analysis on the overall population for the scoring system had an AUC of 0.774 (95% CI 0.668–0.880, the best threshold at 12.5) Conclusions We created a tool based on ASA-PS, length of surgery, and tumor volume to evaluate the risk for ICU admission after supratentorial tumor resection. Prospective studies are deemed necessary to validate our tool.
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