To assess the feasibility of discharge on post-operative day one (POD1) after craniotomy for tumour resection and examine factors associated with delayed discharge and unplanned readmission within 30 days.
Approach:
Study Design: A retrospective analysis of 263 neuro-oncology patients who underwent craniotomy for tumour resection between November 2022 and December 2023.
Eligibility Criteria: POD1 discharge suitability was assessed using functional status, medical frailty, expected recovery, and ability to mobilize safely after surgery. Discharge timing was determined by the treating team.
Data Collection: Demographic, clinical, and operative data were collected from electronic medical records, including length of stay and unplanned readmissions within 30 days.
Statistical Analysis: Fisher’s exact test and univariable logistic regression were used to examine associations with POD1 discharge and 30-day readmission. These analyses identify associations and do not establish causation.
Key Findings:
146 of 263 patients (55.5%) were discharged on POD1.
Unplanned readmission within 30 days occurred in 21 of 263 patients (8.0%).
Among patients discharged on POD1, 11 of 146 (7.5%) had an unplanned readmission within 30 days.
Limitations:
The retrospective design and clinical selection of patients for early discharge may introduce selection bias and limit conclusions about the safety or suitability of POD1 discharge for other patients.
The findings are from a single study cohort and may not generalize to other settings or patient populations.
The sample size may limit the precision of estimates, particularly for readmission outcomes.
Conclusion:
POD1 discharge was achieved in more than half of the patients in this cohort, and 7.5% of those discharged on POD1 had an unplanned readmission within 30 days. These findings suggest that POD1 discharge may be feasible for selected patients, but the retrospective design and clinical selection of patients limit conclusions about its safety or broader applicability.
by Krishmila Yogeswaran, Frederick Ewbank, Rebecca Khoo, Daniel O’flaherty, Md Islam, Antony Kaldas, Arif Zafar, Andrew Durnford, Paul Grundy, Joy Roach
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