Incurring detriments of unplanned readmission to the intensive care unit following surgery for brain metastasis
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Published:2023-06-29
Issue:1
Volume:46
Page:
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ISSN:1437-2320
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Container-title:Neurosurgical Review
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language:en
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Short-container-title:Neurosurg Rev
Author:
Schweppe Justus August,Potthoff Anna-Laura,Heimann Muriel,Ehrentraut Stefan Felix,Borger Valeri,Lehmann Felix,Schaub Christina,Bode Christian,Putensen Christian,Herrlinger Ulrich,Vatter Hartmut,Schäfer Niklas,Schuss Patrick,Schneider Matthias
Abstract
Abstract
Object
Postoperative intensive care unit (ICU) monitoring is a common regime after neurosurgical resection of brain metastasis (BM). In comparison, unplanned secondary readmission to the ICU after initial postoperative treatment course occurs in response to adverse events and might significantly impact patient prognosis. In the present study, we analyzed the potential prognostic implications of unplanned readmission to the ICU and aimed at identifying preoperatively collectable risk factors for the development of such adverse events.
Methods
Between 2013 and 2018, 353 patients with BM had undergone BM resection at the authors’ institution. Secondary ICU admission was defined as any unplanned admission to the ICU during the initial hospital stay. A multivariable logistic regression analysis was performed to identify preoperatively identifiable risk factors for unplanned ICU readmission.
Results
A total of 19 patients (5%) were readmitted to the ICU. Median overall survival (mOS) of patients with unplanned ICU readmission was 2 months (mo) compared to 13 mo for patients without secondary ICU admission (p<0.0001). Multivariable analysis identified “multiple BM” (p=0.02) and “preoperative CRP levels > 10 mg/dl” (p=0.01) as significant and independent predictors of secondary ICU admission.
Conclusions
Unplanned ICU readmission following surgical therapy for BM is significantly related to poor OS. Furthermore, the present study identifies routinely collectable risk factors indicating patients that are at a high risk for unplanned ICU readmission after BM surgery.
Funder
Universitätsklinikum Bonn
Publisher
Springer Science and Business Media LLC
Subject
Neurology (clinical),General Medicine,Surgery
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