Clinical Report: Discharge on the First Post-operative Day After Tumour Resection via Craniotomy

Overview

This study evaluates the feasibility of discharging patients on the first post-operative day (POD1) after craniotomy for tumor resection. It identifies factors associated with delayed discharge and unplanned readmissions within 30 days, based on a retrospective analysis of 263 consecutive neuro-oncology patients.

Background

Traditionally, patients undergoing craniotomy for tumor resection have remained hospitalized for several days for monitoring and recovery. However, reducing post-operative length of stay (LOS) is increasingly recognized in some studies as a potential indicator of efficient recovery and resource utilization. Enhanced Recovery After Surgery (ERAS) pathways have shown that LOS can be shortened without compromising patient safety.

Data Highlights

Key Findings

• POD1 discharge was achieved in 55.5% of patients.

• The overall 30-day unplanned readmission rate was 8.0%.

• Patients discharged on POD1 had a 30-day readmission rate of 7.5%.

• Good pre-operative functional status was predictive of POD1 discharge.

• Factors contributing to prolonged LOS included administrative and logistic issues.

Clinical Implications

The findings indicate that selected patients may be discharged on POD1 after craniotomy for tumor resection. Careful patient selection based on pre-operative functional status is essential for successful implementation.

Conclusion

The study supports the feasibility of POD1 discharge after craniotomy for tumor resection, with no increased odds of readmission compared to later discharge.

Related Resources & Content

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7. AANN Brain Tumor Clinical Practice Guideline

8. Level of evidence of enhanced recovery after surgery (ERAS) strategies for elective craniotomy

9. 2024 AHA/ACC/ACS/ASNC/HRS/SCA/SCCT/SCMR/SVM Guideline for Perioperative Cardiovascular Management for Noncardiac Surgery: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines | JACC

10. Post-operative day one discharge following craniotomy for tumour resection | Journal of Neuro-Oncology | Springer Nature Link

11. Necessary Intensity of Monitoring After Elective Craniotomies: A Prediction Score for Postoperative Complications to Stratify Postoperative Monitoring | Neurocritical Care | Springer Nature Link