Adults withon-screen brain tumor sacliver surgery do not require regular icU

Patients with open craniofacial surgery are routinely admitted to the Neurosurgery Intensive Care Unit (ICU) or sub-intensive care unit (medium care unit, MCU) for the first 12-24 hours after surgery and are transferred to the general unit the next day, with the aim of detecting serious postoperative complications such as bleeding, epilepsy and edema as early as possibleHowever, the need to move into the ICU after the cranial operation has been questionedStudies have shown that the incidence of serious postoperative complications is low, the general level of monitoring is sufficient to meet the needs of specific patients, in addition, most postoperative complications, such as a sexual nerve dysfunction, infection, cerebrospinal fluid circulation disorders, etcdo not require urgent intervention, and patients reflect that staying in the ICU increases mental stress and affects sleepMark ter Laan of the University Medical Center of Nemegen University, the Netherlands, conducted a satisfaction survey of the regular admission to THE ICU or MCU after the opening of the brain tumor, as well as the assessment of the TIME of admission to the ICU, the incidence of complications, and the cost of the study, which was published in the January 2020 issue of Neurosurgeryresearch methodologyresearchers forward-looking to implement the "No-Stay ICU" policy for 109 patients after craniofacial surgery and from April 1, 2016 to 2017 Data on 107 surgical patients who performed the "Stay in ICU unless" policy was conducted on March 31, comparing to assess: (1) the incidence of complications and length of hospitalization in the ICU before and after the implementation of the two policies; The subjects were all adult patients aged 18 years who had open-cranial surgery for on-screen brain tumors, excluding simple skull tumors, pituitary tumors and endoscopic surgerythe resultsfindings suggest that there was no significant difference in age, gender, ASA scores and surgical types among patients included in the two groups"No admission to the ICU, unless" policy was implemented, the ICU or MCU occupancy rate decreased from 64% to 24%, the cost decreased by 13.3% (total 1950 euros per patient), but did not increase the length of stay in the neurosurgery wardThe incidence of complications decreased significantly in the 30 days after the implementation of the new policy (P-0.003), while the incidence of serious complications in both queues (Clavien-Dindo classification 2) was lowerOverall, fewer patients developed complications in the new policy queueIn addition, patients surveyed after the implementation of the new policy were reflected in feeling safer and more relaxed in neurosurgery wards and receiving adequate restconclusions
the authors note that the results show that adult patients with on-screen brain tumors do not need to be regularly admitted to the ICU or MCU, changing the policy from "staying in the ICU, unless" to "no ICU, unless" can reduce the incidence of complications, reduce the length of hospital stay, reduce hospital costs and improve patient satisfaction.