Safety outcomes associated with hospital discharge within 24 hours of awake-craniotomy for brain tumor resection in a comprehensive cancer setting
Author(s): ,
A. Etame
Affiliations:
Moffitt Cancer Center/University of South Florida College of Medicine, Tampa, United States
,
A. Groshev
Affiliations:
Moffitt Cancer Center/University of South Florida College of Medicine, Tampa, United States
,
D. Padalia
Affiliations:
Moffitt Cancer Center/University of South Florida College of Medicine, Tampa, United States
,
R. Garcia-Getting
Affiliations:
Moffitt Cancer Center/University of South Florida College of Medicine, Tampa, United States
,
S. Patel
Affiliations:
Moffitt Cancer Center/University of South Florida College of Medicine, Tampa, United States
,
R. Keenan
Affiliations:
Moffitt Cancer Center/University of South Florida College of Medicine, Tampa, United States
F. Vrionis
Affiliations:
Florida Atlantic University/Marcus Neuroscience Institute, Boca Raton, United States
EANS Academy. Etame A. 11/01/17; 189155; EP483 Topic: Approaches & Anatomy
Prof. Dr. Arnold Etame
Prof. Dr. Arnold Etame

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Abstract: 1207

Topic: Approaches and Reconstructive Techniques

Safety outcomes associated with hospital discharge within 24 hours of awake-craniotomy for brain tumor resection in a comprehensive cancer setting

A. Etame1, A. Groshev1, D. Padalia1, R. Garcia-Getting1, S. Patel1, R. Keenan1, F. Vrionis2

1Moffitt Cancer Center/University of South Florida College of Medicine, Tampa, United States, 2Florida Atlantic University / Marcus Neuroscience Institute, Boca Raton, United States

Background: Discharge within 24 hours following craniotomy is not a routine practice and therefore the safety and quality outcomes are unknown. To assess safety outcomes associated with hospital discharge within 24 hours of awake-craniotomy for brain tumor resection in a comprehensive cancer setting.

Methods: Using an IRB protocol, we retrospectively reviewed and identified all patients who underwent awake-craniotomy and were discharged within 24 hours of tumor resection in a single comprehensive cancer center setting. Charts were reviewed from September 2012 - February 2015 for patient age, sex, cancer type, surgery, brain tumor location, 24-hour discharge, 48-hour unplanned re-admissions status which is the gold standard for safety, myocardial infarctions (MI), deep venous thrombosis (DVT), and pulmonary embolism (PE).

Results: 53 patient charts who met the objectives were identified and analyzed. All patients were discharged home from the ICU within 24-hours of brain tumor resection via awake-craniotomy. All patients had postoperative MRI imaging to assess resection and potential complications. All patients were independently evaluated by physical and occupational therapy and deemed safe for discharge. There were 31 male adult patients and 22 female patients. The mean age was 56 years. Tumor pathologies include 24 metastases (45%), 15 glioblastomas (28%), 10 Grade III gliomas (19%), 3 Grade II gliomas (6%), and 1 meningioma (2%). The most common tumor location was rolandic cortex (motor). 4% of patients had partial resection while 96% had gross total/near-gross total tumor resection (maximum-safe resection). Following discharge, the 48-hour re-admission rate was 0% in this cohort. Post-operative rates for MI, DVT, and PE were 0%.

Conclusions: In a comprehensive cancer setting, patients undergoing craniotomy for resection of brain tumors were safely discharged home within 24 hours of surgery following an uncomplicated perioperative course, a re-assuring postoperative MRI review, and clearance by physiotherapy.
Abstract: 1207

Topic: Approaches and Reconstructive Techniques

Safety outcomes associated with hospital discharge within 24 hours of awake-craniotomy for brain tumor resection in a comprehensive cancer setting

A. Etame1, A. Groshev1, D. Padalia1, R. Garcia-Getting1, S. Patel1, R. Keenan1, F. Vrionis2

1Moffitt Cancer Center/University of South Florida College of Medicine, Tampa, United States, 2Florida Atlantic University / Marcus Neuroscience Institute, Boca Raton, United States

Background: Discharge within 24 hours following craniotomy is not a routine practice and therefore the safety and quality outcomes are unknown. To assess safety outcomes associated with hospital discharge within 24 hours of awake-craniotomy for brain tumor resection in a comprehensive cancer setting.

Methods: Using an IRB protocol, we retrospectively reviewed and identified all patients who underwent awake-craniotomy and were discharged within 24 hours of tumor resection in a single comprehensive cancer center setting. Charts were reviewed from September 2012 - February 2015 for patient age, sex, cancer type, surgery, brain tumor location, 24-hour discharge, 48-hour unplanned re-admissions status which is the gold standard for safety, myocardial infarctions (MI), deep venous thrombosis (DVT), and pulmonary embolism (PE).

Results: 53 patient charts who met the objectives were identified and analyzed. All patients were discharged home from the ICU within 24-hours of brain tumor resection via awake-craniotomy. All patients had postoperative MRI imaging to assess resection and potential complications. All patients were independently evaluated by physical and occupational therapy and deemed safe for discharge. There were 31 male adult patients and 22 female patients. The mean age was 56 years. Tumor pathologies include 24 metastases (45%), 15 glioblastomas (28%), 10 Grade III gliomas (19%), 3 Grade II gliomas (6%), and 1 meningioma (2%). The most common tumor location was rolandic cortex (motor). 4% of patients had partial resection while 96% had gross total/near-gross total tumor resection (maximum-safe resection). Following discharge, the 48-hour re-admission rate was 0% in this cohort. Post-operative rates for MI, DVT, and PE were 0%.

Conclusions: In a comprehensive cancer setting, patients undergoing craniotomy for resection of brain tumors were safely discharged home within 24 hours of surgery following an uncomplicated perioperative course, a re-assuring postoperative MRI review, and clearance by physiotherapy.
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