AANS Online Scientific Session: Socioeconomic-Safety And Costs Analysis Of Early Hospital Discharge After Brain Tumor Surgery: A Pilot Study

Video Transcription

Video Summary

In this video, Alexandra Santos, a medical student from the University of São Paulo, presents a pilot study on the safety and cost analysis of early discharge after brain tumor surgery. The concept of fast-track surgery was introduced in 1994 to optimize postoperative recovery, reduce hospital stay, and minimize complications. Despite this, many neurosurgeons do not follow this concept. A randomized clinical trial last year showed that following the Enhanced Recovery After Surgery (ERAS) protocol resulted in a decrease in hospital length of stay and time to first food intake. The Cancer Institute of São Paulo adopted a Daily Algorithm for Hospital Discharge (DAHD) and conducted a retrospective cohort study to evaluate its impact. Patients were discharged on postoperative day 1 if they met certain criteria and were only kept inpatient if necessary. Blood tests and CT scans were performed as needed. Comparing the pre- and post-implementation groups, there was a decrease in length of stay (5 days before, 3 days after) and a higher proportion of patients discharged within 2 days after surgery (3% before, 44% after). Complications, readmissions, and mortality were comparable between the groups, while the post-implementation group had fewer readmissions. There was a significant reduction in the median costs of hospitalization in the post-implementation group due to a decrease in ward costs. The study concludes that implementing a protocol for early discharge after brain tumor surgery is safe and leads to a significant reduction in hospital length of stay and costs.

Asset Subtitle

Alexandra Santos

Keywords

early discharge after brain tumor surgery

fast-track surgery

Enhanced Recovery After Surgery (ERAS)

length of stay

ward costs