EAJAIC

The Eurasian Journal of Anesthesiology and Intensive Care (EAJAIC) is an independent-unbiased, peer-reviewed, "double-blind", and open-access journal of current national and international issues and reviews for original clinical and experimental research, interesting case reports, differential diagnoses, editorial opinions, letters to the editor, and educational papers in anesthesiology, algology, and intensive care medicine.

EndNote Style
Index
Original Article
Length of stay in intensive care unit and factors associated with clinical outcomes in patients with postoperative intracranial masses
Aims: This study aimed to evaluate factors associated with intensive care unit (ICU) length of stay (LOS) and mortality in patients who underwent surgical intervention for postoperative intracranial masses and required ICU monitoring.
Methods: This retrospective, single-center observational study included adult patients who underwent intracranial mass surgery and were followed in the ICU for at least 48 hours between January 2017 and December 2025. Demographic characteristics, comorbidities, tumor-related variables, clinical scores (Glasgow Coma Scale and APACHE II), need for and duration of mechanical ventilation, ICU complications, LOS, and mortality were recorded. Prolonged ICU stay was defined as >3 days. Univariate and multivariate logistic regression analyses were performed to identify independent predictors of prolonged ICU stay.
Results: A total of 128 patients were included. The median ICU LOS was 3 days, and ICU mortality was 25.8%. Mechanical ventilation requirement, ventilation duration, respiratory complications, and higher APACHE II scores were significantly associated with both ICU LOS and mortality. In multivariate analysis, the APACHE II score was the only independent predictor of prolonged ICU stay (OR: 0.924, 95% CI: 0.862–0.991; p = 0.027). Tumor type showed an association with ICU LOS in univariate analyses, whereas tumor location was not independently associated with outcomes.
Conclusion: In patients with postoperative intracranial masses, ICU LOS and mortality are primarily influenced by acute clinical severity and systemic complications rather than tumor characteristics. The APACHE II score is an independent predictor of prolonged ICU stay, highlighting the importance of early risk stratification to optimize ICU resource utilization.


1. Bonneville F, Jäger HR, Smirniotopoulos JG. Differential diagnosis of intracranial masses. In: Hodler J, Kubik-Huch RA, Roos JE, eds. Diseases of the Brain, Head and Neck, Spine. 2024-2027: Diagnostic Imaging. Cham, Switzerland: Springer; 2024: Chapter 8.
2. Faraj CA, Snyder RI, McCutcheon IE. Intracranial emergencies in neurosurgical oncology: pathophysiology and clinical management. Emerg Cancer Care. 2022;1:13. doi:10.1186/s44201-022-00013-6
3. Narvaez-Rojas AR, Mo-Carrascal J, Maraby J, et al. Neurocritical care of intracranial brain tumor surgery: an overview. MAMC J Med Sci. 2018;4(1):4-11. doi:10.4103/mamcjms.mamcjms_79_17
4. Lonjaret L, Guyonnet M, Berard E, et al. Postoperative complications after craniotomy for brain tumor surgery. Anaesth Crit Care Pain Med. 2017;36(4):213-218. doi:10.1016/j.accpm.2016.06.012
5. Agboola OO, Idowu OO, Balogun JA. Postoperative intensive care unit admission for elective brain tumour surgeries: a Nigerian neurosurgical unit experience. Ann Ib Postgrad Med. 2023;21(2):44-52.
6. Phillips KR, Enriquez-Marulanda A, Mackel C, et al. Predictors of extended length of stay related to craniotomy for tumor resection. World Neurosurg. 2023;19:100176. doi:10.1016/j.wnsx.2023.100176
7. Thommen R, Kazim SF, Rumalla K, et al. Preoperative frailty measured by risk analysis index predicts complications and poor discharge outcomes after brain tumor resection in a large multicenter analysis. J Neurooncol. 2022;160:763-772. doi:10.1007/s11060-022-04212-3
8. Azumi M, Mizobuchi Y, Nakanishi N, et al. Value of the Acute Physiology and Chronic Health Evaluation II score in predicting hospital mortality for postoperative brain tumor patients in intensive care units in Japan: a retrospective case-control study. Clin Neurol Neurosurg. 2024;244:108435. doi:10.1016/j.clineuro.2024.108435
9. Moitra VK, Guerra C, Linde-Zwirble WT, Wunsch H. Relationship between ICU length of stay and long-term mortality for elderly ICU survivors. Crit Care Med. 2016;44(4):655-662. doi:10.1097/CCM. 0000000000001480
10. Neumann JO, Schmidt S, Nohman A, Jakobs M, Unterberg A. Routine ICU admission after brain tumor surgery: retrospective validation and critical appraisal of two prediction scores. Acta Neurochir (Wien). 2023; 165(6):1655-1664. doi:10.1007/s00701-023-05592-9
11. de Almeida CC, Boone MD, Laviv Y, et al. The utility of routine intensive care admission for patients undergoing intracranial neurosurgical procedures: a systematic review. Neurocrit Care. 2018;28:35-42. doi:10. 1007/s12028-017-0433-4
12. De la Garza-Ramos R, Kerezoudis P, Tamargo RJ, Brem H, Huang J, Bydon M. Surgical complications following malignant brain tumor surgery: an analysis of 2002-2011 data. Clin Neurol Neurosurg. 2016; 140:6-10. doi:10.1016/j.clineuro.2015.11.005
13. Nuño M, Carico C, Mukherjee D, et al. Association between in-hospital adverse events and mortality for patients with brain tumors. J Neurosurg. 2015;123:1247-1255. doi:10.3171/2014.10.JNS141516
14. Decavèle M, Weiss N, Rivals I, et al. Prognosis of patients with primary malignant brain tumors admitted to the intensive care unit: a two-decade experience. J Neurol. 2017;264:2303-2312. doi:10.1007/s00415-017-8624-7
15. Tabouret E, Boucard C, Devillier R, et al. Neuro-oncological patients admitted in intensive-care unit: predictive factors and functional outcome. J Neurooncol. 2016;127:111-117. doi:10.1007/s11060-015-2015-7
16. Cho DY, Wang YC. Comparison of the APACHE III, APACHE II, and Glasgow Coma Scale in acute head injury for prediction of mortality and functional outcome. Intensive Care Med. 1997;23:77-84. doi:10. 1007/s001340050294
17. Schuss P, Lehmann F, Schäfer N, et al. Postoperative prolonged mechanical ventilation in patients with newly diagnosed glioblastoma—an unrecognized prognostic factor. Front Oncol. 2020;10:607557. doi:10. 3389/fonc.2020.607557
18. Schuss P, Schäfer N, Bode C, et al. The impact of prolonged mechanical ventilation on overall survival in patients with surgically treated brain metastases. Front Oncol. 2021;11:658949. doi:10.3389/fonc.2021.658949
19. Cote DJ, Smith TR. Venous thromboembolism in brain tumor patients. J Clin Neurosci. 2016;25:13-18. doi:10.1016/j.jocn.2015.05.053
20. Gordon HS, Rosenthal GE. The relationship of gender and in-hospital death: increased risk of death in men. Med Care. 1999;37:318-324. doi: 10.1097/00005650-199903000-00011
Volume 3, Issue 1, 2026
Page : 16-21
_Footer