Highlights
- •Stereotactic brain biopsies have a very low rate of morbidity and mortality.
- •Brain biopsy patients can recover on a neurosurgical ward; ICU care is not needed.
- •Eliminating postoperative head CT and ICU admission will decrease healthcare costs.
Abstract
The study objective was to evaluate a single institution experience with adult stereotactic
intracranial biopsies and review any projected cost savings as a result of bypassing
intensive care unit (ICU) admission and limited routine head computed tomography (CT).
The authors retrospectively reviewed all stereotactic intracranial biopsies performed
at a single institution between February 2012 and March 2019. Primary data collection
included ICU length of stay (LOS), hospital LOS, ICU interventions, need for reoperation,
and CT use. Secondarily, location of lesion, postoperative hematoma, neurological
deficit, pathology, and preoperative coagulopathy data were collected. There were
97 biopsy cases (63% male). Average age, ICU LOS, and total hospital stay were 58.9 years
(range; 21–92 years), 2.3 days (range; 0–40 days), and 8.8 days (range 1–115 days),
respectively. Seventy-five (75 of 97) patients received a postoperative head CT. No
patients required medical or surgical intervention for complications related to biopsy.
Eight patients required transfer from the ward to the ICU (none directly related to
biopsy). Nine patients transferred directly to the ward postoperatively (none required
transfer to ICU). Of the patients who did not receive CT or went directly to the ward,
none had extended LOS or required transfer to ICU for neurosurgical concerns. Eliminating
routine head CT and ICU admission translates to approximately $584,971 in direct cost
savings in 89 cases without a postoperative ICU requirement. These practice changes
would save patients’ significant hospitalization costs, decrease healthcare expenditures,
and allow for more appropriate hospital resource use.
Keywords
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Article info
Publication history
Accepted:
February 7,
2021
Received:
August 31,
2020
Identification
Copyright
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