2022
DOI: 10.1097/ccm.0000000000005588
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Reexamining the Role of Postoperative ICU Admission for Patients Undergoing Elective Craniotomy: A Systematic Review*

Abstract: The standard-of-care for postoperative care following elective craniotomy has historically been ICU admission. However, recent literature interrogating complications and interventions during this postoperative ICU stay suggests that all patients may not require this level of care. Thus, hospitals began implementing non-ICU postoperative care pathways for elective craniotomy. This systematic review aims to summarize and evaluate the existing literature regarding outcomes and costs for patients receiving non-ICU… Show more

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Cited by 7 publications
(9 citation statements)
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“…Clinical inertia has since set in: where a practice pattern set in motion stays in motion until the approach is revisited. However, much like the approach to early broad-spectrum antibiotics, or daily laboratories, new information (such as that provided by Azad et al [8] in this systematic review) warrants questioning of the existing practice paradigm. ICU utilization stewardship is particularly important in an era where the COVID-19 pandemic and increasing healthcare costs have highlighted the need for rationing and appropriate resource utilization.…”
mentioning
confidence: 98%
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“…Clinical inertia has since set in: where a practice pattern set in motion stays in motion until the approach is revisited. However, much like the approach to early broad-spectrum antibiotics, or daily laboratories, new information (such as that provided by Azad et al [8] in this systematic review) warrants questioning of the existing practice paradigm. ICU utilization stewardship is particularly important in an era where the COVID-19 pandemic and increasing healthcare costs have highlighted the need for rationing and appropriate resource utilization.…”
mentioning
confidence: 98%
“…Nonetheless, this study highlights important next steps in this process. Key questions now are as follows: 1) how robust and generalizable are the findings by Azad et al (8)? 2) how do we rigorously develop and standardize protocols with enough flexibility to account for site-specific variability to identify the patient subpopulations that do need ICU level care?…”
mentioning
confidence: 99%
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