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dc.contributor.authorHanak, Brian W.
dc.contributor.authorWalcott, Brian
dc.contributor.authorNahed, Brian Vala
dc.contributor.authorMuzikansky, Alona
dc.contributor.authorMian, Matthew Kamal
dc.contributor.authorKimberly, William Taylor
dc.contributor.authorCurry, William Thomas
dc.date.accessioned2018-05-18T20:41:54Z
dc.date.issued2014
dc.identifier.citationHanak, Brian W., Brian P. Walcott, Brian V. Nahed, Alona Muzikansky, Matthew K. Mian, William T. Kimberly, and William T. Curry. 2014. Postoperative Intensive Care Unit Requirements After Elective Craniotomy. World Neurosurgery 81, no. 1: 165–172. doi:10.1016/j.wneu.2012.11.068.en_US
dc.identifier.issn1878-8750en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:37034626
dc.description.abstractObjective: Commonly, patients undergoing craniotomy are admitted to an intensive care setting post-operatively to allow for close monitoring. We aim to determine the frequency with which patients who have undergone elective craniotomies require intensive care unit level interventions or experience significant complications during the post-operative period to identify a subset of patients for whom an alternative to ICU level care may be appropriate. Methods: Following Institutional Review Board approval, a prospective, consecutive cohort of adult patients undergoing elective craniotomy was established at the Massachusetts General Hospital between the dates of April 2010 and March 2011. Inclusion criteria were intradural operations requiring craniotomy performed on adults (18 years of age or greater). Exclusion criteria were cases of an urgent or emergent nature, patients who remained intubated post-operatively, and patients who had a ventriculostomy drain in place at the conclusion of the case. Results: 400 patients were analyzed. Univariate analysis revealed that diabetics (p = 0.00047), patients who required intra-operative blood product administration (p = 0.032), older patients (p < 0.0001), patients with higher intra-operative blood losses (p = 0.041), and patients who underwent longer surgical procedures (p = 0.021) were more likely to require ICU-level interventions or experience significant post-operative complications. Multivariate analysis only found diabetes (p = 0.0005) and age (p = 0.0091) to be predictive of a patient’s need for post-operative intensive care unit admission. Conclusions: Diabetes and older age predict the need for ICU-level intervention after elective craniotomy. Properly selected patients may not require post-craniotomy ICU monitoring. Further study of resource utilization is necessary to validate these preliminary findings, particularly in different hospital types.en_US
dc.language.isoen_USen_US
dc.publisherElsevier BVen_US
dc.relation.isversionofdoi:10.1016/j.wneu.2012.11.068en_US
dc.relation.hasversionhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3596491/en_US
dash.licenseLAA
dc.subjectelectiveen_US
dc.subjectcraniotomyen_US
dc.subjectintensive care uniten_US
dc.subjectICUen_US
dc.subjectpost-operative careen_US
dc.titlePostoperative Intensive Care Unit Requirements After Elective Craniotomyen_US
dc.typeJournal Articleen_US
dc.description.versionAccepted Manuscripten_US
dc.relation.journalWorld Neurosurgeryen_US
dash.depositing.authorNahed, Brian Vala
dc.date.available2018-05-18T20:41:54Z
dc.identifier.doi10.1016/j.wneu.2012.11.068*
dash.contributor.affiliatedKimberly, William
dash.contributor.affiliatedMian, Matthew
dash.contributor.affiliatedWalcott, Brian
dash.contributor.affiliatedNahed, Brian
dash.contributor.affiliatedCurry, William
dc.identifier.orcid0000-0001-7803-9683


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