Emal Lesha, Jordan T Roach, L Erin Miller, C Stewart Nichols, Brandy Vaughn, David G Laird, Taylor Orr, Delaney Graham, Mustafa Motiwala, Nir Shimony, Paul Klimo
{"title":"Length of stay following elective craniotomy for tumor resection in children and young adults: a retrospective case series.","authors":"Emal Lesha, Jordan T Roach, L Erin Miller, C Stewart Nichols, Brandy Vaughn, David G Laird, Taylor Orr, Delaney Graham, Mustafa Motiwala, Nir Shimony, Paul Klimo","doi":"10.1007/s11060-024-04887-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Length of stay (LOS) is a critical metric of healthcare delivery. Prolonged LOS is associated with a heightened risk of adverse complications. We aimed to provide a comprehensive evaluation of LOS, specifically identifying variables associated with extended LOS (eLOS), in children and young adults following elective craniotomy for tumor resection.</p><p><strong>Methods: </strong>All elective craniotomies for tumor resection performed at our tertiary care children's hospital from January 2010 to December 2022 were included for review, excluding patients > 21 years of age. Demographic, clinical, and procedural variables for each craniotomy were collected. LOS was defined as the interval in days from index surgery to discharge. eLOS was defined as greater than 7 days.</p><p><strong>Results: </strong>1,276 patients underwent a total of 1,497 elective craniotomies for tumor resection. The median age was 9.45 years old, with the most common age group being > 10 years (45.6%). Most patients had supratentorial tumors (63.4%) and underwent de novo surgery (60.7%). Patients with an eLOS experienced longer ICU admissions, longer surgical times, and were younger. Variables found to be significantly associated with eLOS were posterior fossa resection (OR = 2.45), de novo craniotomy (OR = 0.49), prior shunt or ETV (OR = 1.80), tumor type (craniopharyngioma (OR = 3.74) and medulloblastoma (OR = 0.51)), and the presence of at least one postoperative event (POE) (OR = 29.85).</p><p><strong>Conclusion: </strong>This is the largest study evaluating factors (patient, tumor, surgical) associated with eLOS after elective craniotomy for tumor resection in children and young adults. The findings of this clinical study are important for preoperative counseling, neurosurgical team preparedness, and healthcare delivery optimization.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Neuro-Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11060-024-04887-w","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: Length of stay (LOS) is a critical metric of healthcare delivery. Prolonged LOS is associated with a heightened risk of adverse complications. We aimed to provide a comprehensive evaluation of LOS, specifically identifying variables associated with extended LOS (eLOS), in children and young adults following elective craniotomy for tumor resection.
Methods: All elective craniotomies for tumor resection performed at our tertiary care children's hospital from January 2010 to December 2022 were included for review, excluding patients > 21 years of age. Demographic, clinical, and procedural variables for each craniotomy were collected. LOS was defined as the interval in days from index surgery to discharge. eLOS was defined as greater than 7 days.
Results: 1,276 patients underwent a total of 1,497 elective craniotomies for tumor resection. The median age was 9.45 years old, with the most common age group being > 10 years (45.6%). Most patients had supratentorial tumors (63.4%) and underwent de novo surgery (60.7%). Patients with an eLOS experienced longer ICU admissions, longer surgical times, and were younger. Variables found to be significantly associated with eLOS were posterior fossa resection (OR = 2.45), de novo craniotomy (OR = 0.49), prior shunt or ETV (OR = 1.80), tumor type (craniopharyngioma (OR = 3.74) and medulloblastoma (OR = 0.51)), and the presence of at least one postoperative event (POE) (OR = 29.85).
Conclusion: This is the largest study evaluating factors (patient, tumor, surgical) associated with eLOS after elective craniotomy for tumor resection in children and young adults. The findings of this clinical study are important for preoperative counseling, neurosurgical team preparedness, and healthcare delivery optimization.
期刊介绍：
The Journal of Neuro-Oncology is a multi-disciplinary journal encompassing basic, applied, and clinical investigations in all research areas as they relate to cancer and the central nervous system. It provides a single forum for communication among neurologists, neurosurgeons, radiotherapists, medical oncologists, neuropathologists, neurodiagnosticians, and laboratory-based oncologists conducting relevant research. The Journal of Neuro-Oncology does not seek to isolate the field, but rather to focus the efforts of many disciplines in one publication through a format which pulls together these diverse interests. More than any other field of oncology, cancer of the central nervous system requires multi-disciplinary approaches. To alleviate having to scan dozens of journals of cell biology, pathology, laboratory and clinical endeavours, JNO is a periodical in which current, high-quality, relevant research in all aspects of neuro-oncology may be found.
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