Evaluating Patient Outcomes of Postoperative Admission to the Neurosurgery Floor compared to the Intensive Care Unit Following Supratentorial Craniotomy for Brain Tumor Resection

Evaluating Patient Outcomes of Postoperative Admission to the Neurosurgery Floor compared to the Intensive Care Unit Following Supratentorial Craniotomy for Brain Tumor Resection | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Evaluating Patient Outcomes of Postoperative Admission to the Neurosurgery Floor compared to the Intensive Care Unit Following Supratentorial Craniotomy for Brain Tumor Resection Grace Hey, Rachel Moor, Gonghao Liu, Ghaidaa Ebrahim, Kyle McGrath, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7012809/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Introduction: Craniotomy for tumor resection traditionally involves admission to the intensive care unit (ICU) for postoperative monitoring. During the COVID-19 epidemic, all patients who underwent uncomplicated craniotomy for tumor resection were admitted to a regular med-surg floor allowing ICU beds to be reserved for critically ill patients. The objective of this study was to evaluate the safety of this approach and its impact on length of stay (LOS). Methods: A retrospective chart review was conducted on adult patients receiving supratentorial craniotomy for resection of glioma, meningioma, or a metastatic lesion(s), between January 2017 and October 2023 by a single surgeon at our institution. Medical records were reviewed to assess postoperative admission location and complications, which were compared across pre-COVID-19 (2017-2019) and post-COVID-19 (2021-2023) time periods. Comparisons were evaluated by Fisher’s exact test, Wilcoxon rank sum test, and multivariable logistic regression models. Results: Pre-COVID-19, 6% of patients (n = 8) were admitted to the neurosurgery floor whereas 48% of patients (n = 69) were admitted to the floor postop post-COVID-19. Patient demographics, tumor type, tumor location, and Charlson Comorbidity Index (CCI) were similar across both time periods, indicating comparable patient characteristics in the pre-COVID and post-COVID cohorts. Pre-COVID-19 patients admitted to the floor had a trend for reduced LOS (mean (SD): 3.8 (3.2) vs. 5.0 (3.9), p = 0.3) and fewer postoperative complications (12.5% vs. 58.9%, p>0.9). Post-COVID-19, these trends became more statistically significant as the number of patients admitted to the floor, and power, increased. Patients admitted to the floor in the post-COVID-19 era had significantly reduced LOS (3.4 (SD 3.5) vs. 7.1 (SD 9.1) for ICU patients, p<0.001). 30-day readmission rates for patients admitted to the floor demonstrated a decreased trend from pre- to post-COVID-19 (37.5% vs. 14.5%) Conclusion: At our institution, postoperative admission to the neurosurgery floor for supratentorial craniotomy significantly reduced LOS without increased readmissions. Use of ICU beds can be reserved for critically ill patients while reducing LOS of post-craniotomy patients by sending them to the floor after surgery. ICU neurosurgery floor supratentorial craniotomy outcomes COVID Introduction Patients undergoing craniotomy for brain tumor resection require intensive and costly multidisciplinary care that often involves extended postoperative management in the Intensive Care Unit (ICU). Craniotomy patients admitted to the ICU have access to a highly specialized team equipped to manage complex neurological conditions in a timely manner. Continuous neurological assessments, advanced imaging, low patient-to-provider ratios, and immediate availability of life-saving care are known to help optimize patient recovery in the ICU. 1,2 While admission to the ICU may be necessary for some patients, escalation of care to the ICU has been shown to increase hospital length of stay (LOS) and mortality rates. 3-5 Furthermore, being treated in the ICU can pose a significant financial burden for patients and the medical system. 6-10 Common practice for many patients undergoing craniotomy for tumor includes automatic postoperative admission to the ICU, particularly prior to the COVID-19 pandemic. However, the massive influx of critically ill patients to hospitals resulted in a scarcity of ICU beds causing physicians to admit more patients to the general floor for postoperative care. 11-13 This change in standard postoperative management was similarly observed at our institution to preserve critical care resources and allow for appropriate triage of COVID patients. Current data demonstrates that during the COVID-19 pandemic, neurosurgical patients were less frequently admitted to the ICU than before the pandemic. 14 However, few studies have evaluated patient outcomes when admitted to the general neurosurgical floor verses the ICU as a direct consequence of COVID-19 related resource scarcity in the absence of a formal protocol. 15 Mallari et al. found no significant differences in tumor remission, hospital readmission rates, and return to the operating room rates for patients admitted to the floor as compared to the ICU following COVID-19 (2020-2021). 16 These data ultimately suggest that ICU admission maybe not be necessary for successful postoperative recovery, and that admission to the floor may have a positive impact on outcomes for some patients. Given the lack of reports that assess neurosurgical patient outcomes following an unprecedented change in practice on postoperative admission practices, this study aims to retrospectively compare longitudinal supratentorial craniotomy patient outcomes following admission to the neurosurgical floor or ICU. Outcomes were compared for pre- and post-COVID time periods Herein we evaluate and report variables including LOS, mortality, and readmissions to evaluate the safety and potential benefits of this practice. Methods Study Population A retrospective chart review was conducted on patients over the age of 18 who underwent craniotomy for resection of supratentorial glioma, metastatic lesion(s), or meningioma between January 2017 and October 2023 by a single surgeon at our institution. A single surgeon was chosen for this study to minimize variability in postoperative management. Tumor surgeons have variable practice patterns regarding ICU versus floor admission, and there was no significant change in other surgeons' practices before and after COVID-19. However, one surgeon uniquely altered their practice due to the pandemic, providing an opportunity to assess the safety of this change. By focusing on a single surgeon’s patient population, we aimed to reduce confounding factors and better isolate the impact of this practice shift on patient outcomes. IRB approval (IRB202301733) was obtained to conduct this review of adult medical records during the study period. This study was conducted in accordance with institutional guidelines and the Declaration of Helsinki. The requirement for informed consent was waived by the institutional review board. Patients were identified through a search of diagnosis (ICD-9) and procedure (CPT) codes. Patients were excluded from this cohort if they were (a) under the age of 18, (b) underwent craniotomy for an indication other than tumor resection, (c) had an infratentorial tumor resection, or (d) had resection of a skull base meningioma as these patients may have other ICU indications (i.e. ventriculostomy). Data Collection Clinical data in the post-operative setting during patients’ admission and after discharge were collected. Individual patient medical records were assessed for Charlson Comorbidity Index (CCI), intraoperative blood loss, and length of surgery as a means for controlling for complexity of surgery. 17 Postoperative admission location to either the ICU or neurosurgery floor was recorded for all patients. Prior to the COVID-19 pandemic, the default postoperative admission location for the majority of patients was to the ICU. After COVID-19, the default for patients was admission to the floor which was an important change compared to prior to the pandemic. The decision for ICU admission became more focused on a combination of patient comorbidities and case complexity. After COVID, criteria for ICU admission were similar to published literature. 7,9,10,18,19 Patients were admitted to the ICU after discussion with the surgeon and anesthesia attending for increased comorbidities, advanced age, larger tumors with significant cerebral edema, and more rarely for intraoperative hemodynamic instability, new postoperative neurologic impairment, need for vasopressive medication or antihyptensive drips, airway failure requiring a need for mechanical ventilation or presence of external ventricular drain (EVD). 7,18 Discharge, disposition, hospital length of stay, 30-day readmission rates, and 30-day mortality rates were extracted and compared. Postoperative complications experienced during the hospital stay were collected and included acute respiratory failure, deep vein thrombosis (DVT), hematoma, surgical site infection, new neurologic deficits, seizure, and stroke. Acute respiratory failure was defined as patients who required reintubation and mechanical ventilation after successful extubation in the operating room. At our institution, laboratory studies including basic metabolic panel, complete blood count, and blood cultures are not routinely ordered for post-craniotomy. We compared the frequency of these labs when collected within 24 hours after surgery between cohorts to evaluate differences in resource utilization and overall hospitalization costs. These data were gathered to facilitate the early identification of postoperative complications, which can serve as indicators of increased medical complexity. 20,21 This list of complications was developed based on a review of the literature detailing complications implicated in admitting patients to the ICU or general floor following unexpected complications during or after surgery as well as craniotomy-specific complications that are reported quality metrics tied to physician reimbursement. 4,15,22 Measurements Key outcome variables for this study included postoperative admission location and complications. For the analyses that compared outcomes across our two time periods, 2017 – 2019 and 2021 – 2023, patient data from the year 2020 was excluded to serve as a washout period that accounted for the change in admission practice during the COVID-19 pandemic. Statistical Analyses Statistical analyses were conducted using R version 4.4.1. Descriptive statistics including means (Standard Deviation, SD) for continuous variables and frequencies (percentages) for categorical variables, were used to describe the study population. Fisher’s exact test and the Wilcoxon rank sum test were employed to assess associations between admission locations and study patients’ characteristics for categorical variables and continuous variables, respectively, by time-period (Pre-COVID vs. Post-COVID). Multivariable logistic regression model was used to determine the association between admission location (ICU vs. Neurosurgery Floor) and the clinical outcome (postoperative complication: Yes vs. No), while controlling patient demographic and clinical characteristics such as sex, CCI, surgery recurrence, diagnosis, and length of surgery. Results A total of 327 patients who underwent supratentorial craniotomy for glioma, meningioma, metastatic lesion(s), or other were included in this study. 249 patients were admitted to the ICU (62.2% men) and 78 patients (55.1% men) were admitted to the neurosurgery floor during the entire study period (Table 1). Evaluation of ICU versus floor patients during the entire study period found no difference in CCI between the groups, type of tumor, length of surgery, readmission rate, return to the OR, complications or postoperative edema. As expected, the LOS was 5.9 days (SD 6.6) for ICU patients compared to 3.4 days (SD 3.5) (p < 0.001) for patients admitted to the floor. The ICU patients were less likely to be discharged home and had increased likelihood of having lab values collected within 24 hours of surgery. Other complications including death were statistically similar between ICU and floor patients overall (Table 2). Of patients admitted to the neurosurgery floor, 5 (5.4%) were upgraded to the ICU during their hospital stay (Table 3) . All ICU upgrades occurred in the post-COVID-19 timeframe. Next these data were stratified with respect to pre- and post- COVID-19 time periods. Pre-COVID, only 6% of patients were sent to the floor post-operatively and this increased to 48% post-COVID-19 (Table 4) . Post-COVID 19, the patients in the ICU had a trend for higher CCI (4.5) compared to the floor patients (3.9) and this difference was not seen pre-pandemic. The major differences between the pre-COVID and post-COVID cohorts were in length of surgery, LOS, disposition, difference in complication rates and lab values collected within 24 hours. The length of surgery was significantly different between ICU and floor patients pre-COVID (average 2.6 hrs vs. 1.4 hrs, p<0.001) and became insignificant post-COVID (average 3.9 hrs vs. 3.7 hrs, p=0.02). Pre-COVID the different in LOS between the ICU cohort floor cohort was not statistically significant) p=0.3) and it became significantly different post-COVID (LOS for ICU 7.1 days (SD 9.1) vs. 3.4 days (SD 3.5) for the floor patients, p<0.001). Similarly, disposition status was not different between ICU and floor patients pre-COVID (p=0.3) and after the pandemic the floor patients were much more likely to be discharged home (89.9%) compared to the ICU patients (64%) p=0.001. Approximately 58% of patients who were admitted to the ICU underwent routine laboratory studies within 24 hours of surgery both in the Pre-COVID and Post-COVID cohorts. Because a much larger portion of patients were admitted to the floor in the post-COVID period, much fewer patients had routine lab studies ordered after surgery (p=0.004). Lastly, prior to the pandemic risk of complications was similar between ICU and floor patients. After the pandemic, patients admitted to the floor were much less likely to have a complication p=0.004. ( Table 5 ). Multivariable logistic regression analysis revealed no significant association between admission location, CCI, surgery recurrence, diagnosis, and surgery length on the odds of developing complications (Table 6). Discussion The ICU is an invaluable resource that is necessary to provide patients with highly specialized life-saving care. While admission to the ICU may be warranted for critical patients after surgery, the change in admission practices necessitated by the COVID-19 pandemic required surgeons at our institution to be more thoughtful about which patients should be admitted to the ICU following craniotomy for supratentorial tumor. The results of this study are consistent with other reports in the literature where specific protocols have been developed to admit patients to an ICU step-down unit or the general postoperative neurosurgery floor rather than the ICU. 7,9,10,18,19 Admission to an ICU step-down unit provides patients with an intermediate level of care between that of the ICU and the floor. For example, Young et al. 10 developed a “Safe Transitions Pathway” model in which select patients were admitted to an ICU step-down unit rather than the ICU after craniotomy. Patients were included in the Safe Transitions Pathway model if they were under the age of 65, had a supratentorial tumor size < 3 cm, case length < 6 hours, and estimated blood loss < 500mL. 10 Patients in the Safe Transitions Pathway group were found to have significantly decreased LOS and direct cost per case by approximately $422,000. 10 No patients were upgraded to the ICU, returned to the operating room, or died within the study time frame. 10 A later study by Laan et al. 23 implemented a “no ICU, unless” policy to compare outcomes following supratentorial craniotomy when admitted to the ICU or ICU step-down unit. The implementation of this policy was found to provide a 13.3% reduction in cost for patients and significantly reduced postoperative complications without increasing LOS. 23 Patients included in this protocol were interviewed after discharge and reported feeling safe and at ease while admitted to the ICU step-down unit. 23 Perez-Varga et al. 7 developed an ICU step-down unit specifically for craniotomy for tumor patients during the COVID-19 pandemic. Patients were admitted to this intermediate unit if they were found to have no immediate postoperative complications, no signs and symptoms of clinical deterioration, no intracranial pressure monitors, no external ventricular drain, and no use of vasopressors. 7 Patients in this cohort experienced no adverse outcomes with significant financial savings. 7 The safety of ICU step-down admission led several investigators to compare outcomes following admission to the general floor as compared to the ICU. Florman et al. 18 admitted supratentorial craniotomy for tumor patients to the neurosurgery floor rather than the ICU if they were hemodynamically stable with no new postoperative neurologic impairment. The floor admission protocol was created in a multidisciplinary manner based on historical patient outcomes with oversight by all practicing neurosurgeons, neurointensivists, nursing, and the neuro-surgical physical extender group. 18 The results of this study found that patients sent to the floor had significantly shorter LOS and length of surgery with significantly more patients being discharged home. 18 A postoperative post-anesthesia care unit pathway developed by Hoffman et al. 9 was found to significantly reduce LOS in craniotomy for tumor patients treated from January 2021 to January 2022 with no increased risk of early hospital readmission. Patients with case lengths of < 5 hours and estimated blood loss < 500mL were admitted to the floor using this protocol. 9 Ultimately, the level of postoperative care provided to an individual patient should depend on their unique presentation. Previous studies have indicated that craniotomy patients should be admitted to the ICU if they experience hemodynamic instability, severe neurologic complications, significant blood loss, low blood oxygen after extubation, a need for postoperative insulin drip, or duration of surgery longer than six hours. 23-25 Franko et al. 26 observed that less than 10% of supratentorial craniotomy for tumor patients require ICU-level care and developed a 4-point score to guide ICU admission decisions. This score includes a Karnofsky Performance Status less than 70 (1 point), need for general endotracheal anesthesia (1 point), and development of postoperative complications (2 points). The authors of this study found that a greater 4-point prediction score increased the likelihood of requiring ICU-specific care, indicating the use of this 4-point score may aid clinicians in stratifying the need for ICU admission in resource-limited settings. Based on our analysis, patients admitted to the ICU from 2021 to 2023 were more likely to have a higher CCI as compared to patients admitted to the general floor. Implementing a more personalized ICU admission protocol based on specific postoperative criteria and individual patient comorbidities ensures that ICU resources are allocated to the most critical patients, allowing for improved patient outcomes. This approach could additionally lead to a more efficient system that significantly reduces patient costs and unnecessary use of ICU resources. The present study is unique in the sense that our change in practice of admitting patients to the neurosurgery floor rather than the ICU was sudden and in absence of a formal enhanced recovery after surgery protocol. Patients admitted to the ICU and neurosurgical floor prior to the pandemic were similar with respect to CCI, LOS, and postoperative complications. Following the change in practices brought about by the COVID-19 pandemic, our population of patients admitted to the ICU following craniotomy for tumor were more complicated, as indicated by the higher CCI than those admitted to the floor. The increased number of unique postoperative complications following this change in practice for ICU patients may be a direct reflection of this higher complexity of patients, as more critical patients are at a greater risk of developing postoperative complications by nature. The downward trend in 30-day readmission rates for patients admitted to the floor pre-COVID-19 as compared to post-COVID-19 suggests that lower-risk patients were appropriately triaged to the floor rather than the ICU, further supporting this idea. We found this shift in practice patterns to be safe, thus, our decision-making algorithm of sending more critical patients to the ICU and less critical patients to the neurosurgery floor following supratentorial craniotomy for tumor resection was both safe and effective. This finding highlights how admission to the ICU may not be necessary in all cases for safe and successful recovery following supratentorial craniotomy for tumor resection. The limitations of this study include that all patient data were collected from a single surgeon at a single institution, which may have influenced the case distribution and surgical decision-making. The exclusion of other tumors outside of the supratentorial region may introduce selection bias and fail to represent the broader population of all craniotomy patients, although this was done intentionally to limit the confounders that may come with tumors in other locations (i.e. ventriculostomy). Future research efforts should be conducted to analyze data across a variety of neurosurgical pathologies, surgeons, and procedures to improve the validity of this study. Conclusion At our institution, postoperative admission to the neurosurgery floor for supratentorial craniotomy significantly reduced LOS without increased readmissions. Use of ICU beds can be reserved for critically ill patients while reducing LOS of post-craniotomy patients by sending them to the floor after surgery. Abbreviations CCI Charlson Comorbidity Index DVT Deep vein thrombosis ERAS Enhanced Recovery After Surgery ICU Intensive Care Unit LOS Length of Stay OR Odds Ratio SD Standard Deviation Declarations Required Research Reporting Guidelines : None Conflict of Interest : None Disclosure of Funding : No funding was obtained for this work Human Ethics and Consent to Participate declarations: Not applicable Author Contributions: GH: Drafting of original manuscript, revision of manuscript, data collection RM: Drafting of original manuscript, revision of manuscript GL: Drafting of original manuscript, data analysis GE: Data collection KM: Data collection AM: Data collection GP: Data collection JL: Revision of manuscript AD: Revision of manuscript, data collection MR: Project oversight, revision of manuscript, primary surgeon References Whitmore RG, Thawani JP, Grady MS, Levine JM, Sanborn MR, Stein SC. Is aggressive treatment of traumatic brain injury cost-effective? 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Aug 2018;46(8):1302-1308. doi:10.1097/CCM.0000000000003207 Tables Table 1 – Demographic and Clinical Characteristics for All Patients by Admission Location (ICU vs. Neurosurgery Floor) Overall (N = 327) ICU (N = 249) Neurosurgery Floor (N = 78) p-value + Gender 0.3 Male 198 (60.6%) 155 (62.2%) 43 (55.1%) Female 129 (39.4%) 94 (37.8%) 35 (44.9%) CCI 0.2 Mean (SD) 4.2 (2.1) 4.2 (2.1) 4.0 (2.2) Median 4.0 4.0 3.5 Range 0.0 to 14.0 0.0 to 14.0 0.0 to 11.0 Diagnosis 0.6 Glioma 278 (85.0%) 209 (83.9%) 69 (88.5%) Meningioma 6 (1.8%) 6 (2.4%) 0 (0.0%) Metastatic lesion 13 (4.0%) 11 (4.4%) 2 (2.6%) Other * 30 (9.2%) 23 (9.2%) 7 (9.0%) Length of surgery (hours) 0.2 Mean (SD) 3.1 (1.8) 3.0 (1.5) 3.4 (2.5) Median 2.8 2.8 3.1 Range 0.1 to 21.2 0.1 to 10.5 1.0 to 21.2 LOS < 0.001 Mean (SD) 5.3 (6.1) 5.9 (6.6) 3.4 (3.5) Median 3.0 4.0 2.0 Range 0.0 to 68.0 1.0 to 68.0 0.0 to 22.0 Disposition < 0.001 Home 226 (69.1%) 157 (63.1%) 69 (88.5%) Skilled nursing home 2 (0.6%) 2 (0.8%) 0 (0.0%) In-patient rehabilitation 83 (25.4%) 75 (30.1%) 8 (10.3%) Patient died 3 (0.9%) 3 (1.2%) 0 (0.0%) Other* 13 (4.0%) 12 (4.8%) 1 (1.3%) Readmission within 30 days of surgery 55 (16.8%) 42 (16.9%) 13 (16.7%) > 0.9 Return to the operating room within 30 days of surgery 45 (13.8%) 39 (15.7%) 6 (7.7%) 0.090 Mortality within 30 days of surgery 9 (2.8%) 9 (3.6%) 0 (0.0%) 0.12 Total number of patients with complications during hospital stay 49 (15.4%) 44 (18.3%) 5 (6.4%) 0.011 Laboratory values collected within 24 hours of surgery 171 (53.6%) 146 (60.6%) 25 (32.1%) < 0.001 Postoperative edema 167 (51.2%) 121 (51.9%) 46 (49.5%) 0.7 *Diagnosis of “other” refers to patients who had a supratentorial tumor outside of the aforementioned defined diagnoses. Disposition of “other” refers to disposition outside of the aforementioned defined locations. +P-values were calculated with a Fisher’s exact test or Wilcoxon rank sum test CCI – Charlson Comorbidity Index, ICU – Intensive Care Unit, LOS – Length of Hospital Stay, SD – Standard Deviation, Table 2 –Complications During Hospital Stay by Admission Location (ICU vs. Neurosurgery Floor) for All Patients (2017-2019 and 2021-2023) Overall (N = 327) ICU (N = 249) Neurosurgery Floor (N = 78) p-value Acute respiratory failure 4 4 (1.6%) 0 (0.0%) 0.6 Death 3 3 (1.2%) 0 (0.0%) > 0.9 Hematoma 7 6 (2.4%) 1 (1.3%) >0.9 Infection 9 7 (2.8%) 2 (2.6%) >0.9 New neurologic deficits 3 2 (0.8%) 1 (1.3%) 0.6 Seizure 19 16 (6.4%) 3 (3.8%) 0.6 Stroke 7 6 (2.4%) 1 (1.3%) >0.9 DVT 2 2 (0.8%) 0 (0.0%) >0.9 The total number of complications for all patients in this study was extracted and analyzed. For patients with multiple complications, each complication was coded as a unique event. Values are reported as frequency (percent). P-values were calculated with a Fisher’s exact test. DVT = Deep Vein Thrombosis; ICU = Intensive Care Unit Table 3 – Indications for ICU Upgrade from the Neurosurgery Floor Post-COVID-19 (2021-2023). Age/Gender CCI Diagnosis Postoperative Admission Location Indication for ICU Upgrade 74-year-old male 7 GBM Neurosurgery floor Intractable seizures 57-year-old male 3 GBM ICU On postoperative day 9 and 10, the patient became progressively more confused and repeat MRI demonstrated significantly worsened edema, midline shift 63-year-old-male 9 Astrocytoma Neurosurgery floor Patient spontaneously went into atrial fibrillation with rapid ventricular response while on the neurosurgery floor and was upgraded to the ICU the same night. 74-year-old male 6 Meningioma ICU Intractable seizures 60-year-old-male 7 Metastatic melanoma ICU On postoperative day 2 he experienced venous infarct requiring take back to the OR Of the patients admitted to the neurosurgery floor for the entire study timeframe, 5 patients (5.4%) were upgraded from the neurosurgery floor to the ICU. Individual CCI, diagnosis, and indication for ICU upgrade from the neurosurgery floor is reported here. CCI – Charleson Comorbidity Index; GBM – Glioblastoma; ICU – Intensive Care Unit; MRI – Magnetic Resonance Imaging Table 4 – Demographic and Clinical Characteristics by Time Period (2017-2019: Pre-COVID vs. 2021-2023: Post-COVID) and Admission Location (ICU vs. Neurosurgery Floor) 2017 – 2019 2021 – 2023 ICU (N=127) Neurosurgery Floor (N=8) p-value ICU (N=75) Neurosurgery Floor (N=69) p-value Gender 0.5 0.7 Male 80 (63.0%) 4 (50.0%) 45 (60.0%) 39 (56.5%) Female 47 (37.0%) 4 (50.0%) 30 (40.0%) 30 (43.5%) CCI 0.5 0.052 Mean (SD) 4.1 (2.1) 4.1 (1.7) 4.5 (2.3) 3.9 (2.2) Median 4.0 3.5 4.0 3.0 Range 0.0 to 13.0 2.0 to 7.0 2.0 to 14.0 0.0 to 11.0 Diagnosis 0.4 0.091 Glioma 111 (87.4%) 7 (87.5%) 60 (80.0%) 61 (88.4%) Meningioma 2 (1.6%) 0 (0.0%) 3 (4.0%) 0 (0.0%) Metastatic lesion 3 (2.4%) 1 (12.5%) 6 (8.0%) 1 (1.4%) Other * 11 (8.7%) 0 (0.0%) 6 (6.8%) 7 (10.1%) Length of surgery (hours) < 0.001 0.2 Mean (SD) 2.6 (1.0) 1.4 (0.3) 3.9 (1.5) 3.7 (2.5) Median 2.4 1.3 3.6 3.3 Range 0.5 to 5.7 1.2 to 2.0 1.4 to 8.6 1.0 to 21.2 LOS 0.3 < 0.001 Mean (SD) 5.0 (3.9) 3.8 (3.2) 7.1 (9.1) 3.4 (3.5) Median 4.0 3.0 4.0 2.0 Range 1.0 to 19.0 0.0 to 8.0 1.0 to 68.0 0.0 to 22.0 Disposition 0.3 0.001 Home 79 (62.2%) 6 (75%) 48 (64.0%) 62 (89.9%) Skilled nursing home 1 (0.8%) 0 (0.0%) 1 (1.3%) 0 (0.0%) In-patient rehabilitation 41 (32.3%) 1 (12.5%) 21 (28.0%) 7 (10.1%) Patient died 1 (0.8%) 0 (0.0%) 2 (2.7%) 0 (0.0%) Other 5 (3.9%) 1 (12.5%) 3 (4.0%) 0 (0.0%) Readmission within 30 days of surgery 16 (12.6%) 3 (37.5%) 0.084 15 (20.0%) 10 (14.5%) 0.5 Return to operating room within 30 days of surgery 12 (9.4%) 0 (0.0%) > 0.9 13 (17.3%) 6 (8.7%) 0.15 Mortality within 30 days of surgery 3 (2.4%) 0 (0.0%) > 0.9 5 (6.7%) 0 (0.0%) 0.059 Total number of patients with complications during hospital stay 20 (16.1%) 1 (12.5%) > 0.9 15 (20.8%) 4 (5.8%) 0.012 Laboratory values collected within 24 hours of surgery 73 (58.9%) 2 (25.0%) 0.076 42 (58.3%) 23 (33.3%) 0.004 Postoperative edema 59 (50.4%) 9 (47.4%) > 0.9 34 (45.3%) 34 (49.3%) 0.7 Patients treated in the year 2020 were excluded from this analysis because 2020 served as a washout period. Diagnosis of “other” refers to patients who had a supratentorial tumor outside of the aforementioned defined diagnoses. Disposition of “other” refers to disposition outside of the aforementioned defined locations. P-values were calculated with a Fisher’s exact test or Wilcoxon rank sum test CCI – Charlson Comorbidity Index, ICU – Intensive Care Unit, LOS – Length of Hospital Stay, SD – Standard Deviation Table 5 – Complications During Hospital Stay for Patients by Time Period (2017-2019: Pre-COVID vs. 2021-2023: Post-COVID) and Admission Location (ICU vs. Neurosurgery Floor) 2017 - 2019 2021 - 2023 ICU (N=127) Neurosurgery Floor (N=8) p-value ICU (N=75) Neurosurgery Floor (N=69) p-value Acute respiratory failure 2 (1.6%) 0 (0.0%) >0.9 1 (1.3%) 0 (0.0%) >0.9 Death 1 (0.8%) 0 (0.0%) >0.9 2 (2.7%) 0 (0.0%) 0.5 Hematoma 2 (1.6%) 0 (0.0%) >0.9 3 (4.0%) 1 (1.4%) 0.6 Infection 2 (1.6%) 0 (0.0%) >0.9 1 (1.3%) 2 (2.9%) 0.6 New neurologic deficits 1 (0.8%) 0 (0.0%) >0.9 0 (0.0%) 1 (1.4%) 0.5 Seizure 7 (5.5%) 1 (12.5%) 0.4 9 (12.0%) 2 (2.9%) 0.058 Stroke 5 (3.9%) 0 (0.0%) >0.9 1 (1.3%) 0 (0.0%) >0.9 DVT 0 (0.0%) 0 (0.0%) 2 (2.7%) 0 (0.0%) 0.5 The total number of complications for all patients in this study were extracted and analyzed with respect to time period and admission location. For patients with multiple complications, each complication was coded as a unique event. Values are reported as frequency (percent). P-values were calculated with a Fisher’s exact test. DVT = Deep Vein Thrombosis; ICU = Intensive Care Unit Table 6 - Multivariable Logistic Regression Model of Complications (Yes vs. No) for All Patients (2017-2019 and 2021-2023) Odds Ratio (OR) 95% Confidence Interval p-value Neurosurgery floor admission location (ref: ICU) 0.69 0.39, 1.23 0.2 Sex (ref: Male) 0.66 0.40, 1.06 0.090 CCI 1.06 0.93, 1.20 0.4 Recurrent surgery 1.02 0.53, 1.91 >0.9 Diagnosis (ref: Glioma) Meningioma 2.69 0.50, 20.0 0.3 Metastatic lesion 0.45 0.09, 1.81 0.3 Other 1.00 0.43, 2.22 >0.9 Surgery length (hours) 1.04 0.90, 1.19 0.6 Laboratory values collected within 24 hours of surgery 1.35 0.83, 2.21 0.2 CCI – Charlson Comorbidity Index Table 7 - Multivariable Logistic Regression Model of Complications (Yes vs. No) by Time Period (2017-2019: Pre-COVID vs. 2021-2023: Post-COVID) Odds Ratio (OR) 95% Confidence Interval p-value Pre-COVID-19 neurosurgery floor admission location (ref: ICU) 1.89 0.43, 8.33 0.4 Post-COVID-19 neurosurgery floor admission location (ref: ICU) 0.42 0.21, 0.83 0.013 Additional Declarations No competing interests reported. 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Craniotomy patients admitted to the ICU have access to a highly specialized team equipped to manage complex neurological conditions in a timely manner. Continuous neurological assessments, advanced imaging, low patient-to-provider ratios, and immediate availability of life-saving care are known to help optimize patient recovery in the ICU.\u003csup\u003e1,2\u003c/sup\u003e While admission to the ICU may be necessary for some patients, escalation of care to the ICU has been shown to increase hospital length of stay (LOS) and mortality rates.\u003csup\u003e3-5\u003c/sup\u003e Furthermore, being treated in the ICU can pose a significant financial burden for patients and the medical system.\u003csup\u003e6-10\u003c/sup\u003e Common practice for many patients undergoing craniotomy for tumor includes automatic postoperative admission to the ICU, particularly prior to the COVID-19 pandemic. However, the massive influx of critically ill patients to hospitals resulted in a scarcity of ICU beds causing physicians to admit more patients to the general floor for postoperative care.\u003csup\u003e11-13\u003c/sup\u003e This change in standard postoperative management was similarly observed at our institution to preserve critical care resources and allow for appropriate triage of COVID patients.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eCurrent data demonstrates that during the COVID-19 pandemic, neurosurgical patients were less frequently admitted to the ICU than before the pandemic.\u003csup\u003e14\u003c/sup\u003e However, few studies have evaluated patient outcomes when admitted to the general neurosurgical floor verses the ICU as a direct consequence of COVID-19 related resource scarcity in the absence of a formal protocol.\u003csup\u003e15\u003c/sup\u003e Mallari et al. found no significant differences in tumor remission, hospital readmission rates, and return to the operating room rates for patients admitted to the floor as compared to the ICU following COVID-19 (2020-2021).\u003csup\u003e16\u003c/sup\u003e These data ultimately suggest that ICU admission maybe not be necessary for successful postoperative recovery, and that admission to the floor may have a positive impact on outcomes for some patients.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eGiven the lack of reports that assess neurosurgical patient outcomes following an unprecedented change in practice on postoperative admission practices, this study aims to retrospectively compare longitudinal supratentorial craniotomy patient outcomes following admission to the neurosurgical floor or ICU. Outcomes were compared for pre- and post-COVID time periods Herein we evaluate and report variables including LOS, mortality, and readmissions to evaluate the safety and potential benefits of this practice.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cem\u003eStudy Population\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eA retrospective chart review was conducted on patients over the age of 18 who underwent craniotomy for resection of supratentorial glioma, metastatic lesion(s), or meningioma between January 2017 and October 2023 by a single surgeon at our institution.\u0026nbsp;A single surgeon was chosen for this study to minimize variability in postoperative management. Tumor surgeons have variable practice patterns regarding ICU versus floor admission, and there was no significant change in other surgeons' practices before and after COVID-19. However, one surgeon uniquely altered their practice due to the pandemic, providing an opportunity to assess the safety of this change. By focusing on a single surgeon’s patient population, we aimed to reduce confounding factors and better isolate the impact of this practice shift on patient outcomes.\u0026nbsp;IRB approval (IRB202301733) was obtained to conduct this review of adult medical records during the study period. This study was conducted in accordance with institutional guidelines and the Declaration of Helsinki. The requirement for informed consent was waived by the institutional review board. Patients were identified through a search of diagnosis (ICD-9) and procedure (CPT) codes. Patients were excluded from this cohort if they were (a) under the age of 18, (b) underwent craniotomy for an indication other than tumor resection, (c) had an infratentorial tumor resection, or (d) had resection of a skull base meningioma as these patients may have other ICU indications (i.e. ventriculostomy).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eData Collection\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eClinical data in the post-operative setting during patients’ admission and after discharge were collected. Individual patient medical records were assessed for Charlson Comorbidity Index (CCI), intraoperative blood loss, and length of surgery as a means for controlling for complexity of surgery.\u003csup\u003e17\u003c/sup\u003e Postoperative admission location to either the ICU or neurosurgery floor was recorded for all patients. Prior to the COVID-19 pandemic, the default postoperative admission location for the majority of patients was to the ICU. After COVID-19, the default for patients was admission to the floor which was an important change compared to prior to the pandemic. The decision for ICU admission became more focused on a combination of patient comorbidities and case complexity.\u0026nbsp;After COVID, criteria for ICU admission were similar to published literature.\u003csup\u003e7,9,10,18,19\u003c/sup\u003e Patients were admitted to the ICU after discussion with the surgeon and anesthesia attending for increased comorbidities, advanced age, larger tumors with significant cerebral edema, and more rarely for intraoperative hemodynamic instability, new postoperative neurologic impairment, need for vasopressive medication or antihyptensive drips, airway failure requiring a need for mechanical ventilation or presence of external ventricular drain (EVD).\u003csup\u003e7,18\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eDischarge, disposition, hospital length of stay, 30-day readmission rates, and 30-day mortality rates were extracted and compared. Postoperative complications experienced during the hospital stay were collected and included acute respiratory failure, deep vein thrombosis (DVT), hematoma, surgical site infection, new neurologic deficits, seizure, and stroke. Acute respiratory failure was defined as patients who required reintubation and mechanical ventilation after successful extubation in the operating room. At our institution, laboratory studies including basic metabolic panel, complete blood count, and blood cultures are not routinely ordered for post-craniotomy. We compared the frequency of these labs when collected within 24 hours after surgery between cohorts to evaluate differences in resource utilization and overall hospitalization costs.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThese data were gathered to facilitate the early identification of postoperative complications, which can serve as indicators of increased medical complexity.\u003csup\u003e20,21\u003c/sup\u003e This list of complications was developed based on a review of the literature detailing complications implicated in admitting patients to the ICU or general floor following unexpected complications during or after surgery as well as craniotomy-specific complications that are reported quality metrics tied to physician reimbursement.\u003csup\u003e4,15,22\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eMeasurements\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eKey outcome variables for this study included postoperative admission location and complications. For the analyses that compared outcomes across our two time periods, 2017 – 2019 and 2021 – 2023, patient data from the year 2020 was excluded to serve as a washout period that accounted for the change in admission practice during the COVID-19 pandemic.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eStatistical Analyses\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eStatistical analyses were conducted using R version 4.4.1. Descriptive statistics including means (Standard Deviation, SD) for continuous variables and frequencies (percentages) for categorical variables, were used to describe the study population. Fisher’s exact test and the Wilcoxon rank sum test were employed to assess associations between admission locations and study patients’ characteristics for categorical variables and continuous variables, respectively, by time-period (Pre-COVID vs. Post-COVID). Multivariable logistic regression model was used to determine the association between admission location (ICU vs. Neurosurgery Floor) and the clinical outcome (postoperative complication: Yes vs. No), while controlling patient demographic and clinical characteristics such as sex, CCI, surgery recurrence, diagnosis, and length of surgery.\u0026nbsp;\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 327 patients who underwent supratentorial craniotomy for glioma, meningioma, metastatic lesion(s), or other were included in this study. 249 patients were admitted to the ICU (62.2% men) and 78 patients (55.1% men) were admitted to the neurosurgery floor during the entire study period \u003cstrong\u003e(Table 1).\u0026nbsp;\u003c/strong\u003eEvaluation of ICU versus floor patients during the entire study period found no difference in CCI between the groups, type of tumor, length of surgery, readmission rate, return to the OR, complications or postoperative edema. As expected, the LOS was 5.9 days (SD 6.6) for ICU patients compared to 3.4 days (SD 3.5) (p \u0026lt; 0.001) for patients admitted to the floor. The ICU patients were less likely to be discharged home and had increased likelihood of having lab values collected within 24 hours of surgery. Other complications including death were statistically similar between ICU and floor patients overall \u003cstrong\u003e(Table 2).\u0026nbsp;\u003c/strong\u003eOf patients admitted to the neurosurgery floor, 5 (5.4%) were upgraded to the ICU during their hospital stay \u003cstrong\u003e(Table 3)\u003c/strong\u003e.\u0026nbsp;All ICU upgrades occurred in the post-COVID-19 timeframe.\u003c/p\u003e\n\u003cp\u003eNext these data were stratified with respect to pre- and post- COVID-19 time periods. Pre-COVID, only 6% of patients were sent to the floor post-operatively and this increased to 48% post-COVID-19\u0026nbsp;\u003cstrong\u003e(Table 4)\u003c/strong\u003e.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003ePost-COVID 19, the patients in the ICU had a trend for higher CCI (4.5) compared to the floor patients (3.9) and this difference was not seen pre-pandemic. The major differences between the pre-COVID and post-COVID cohorts were in length of surgery, LOS, disposition, difference in complication rates and lab values collected within 24 hours. The length of surgery was significantly different between ICU and floor patients pre-COVID (average 2.6 hrs vs. 1.4 hrs, p\u0026lt;0.001) and became insignificant post-COVID (average 3.9 hrs vs. 3.7 hrs, p=0.02). Pre-COVID the different in LOS between the ICU cohort floor cohort was not statistically significant) p=0.3) and it became significantly different post-COVID (LOS for ICU 7.1 days (SD 9.1) vs. 3.4 days (SD 3.5) for the floor patients, p\u0026lt;0.001). Similarly, disposition status was not different between ICU and floor patients pre-COVID (p=0.3) and after the pandemic the floor patients were much more likely to be discharged home (89.9%) compared to the ICU patients (64%) p=0.001. Approximately 58% of patients who were admitted to the ICU underwent routine laboratory studies within 24 hours of surgery both in the Pre-COVID and Post-COVID cohorts. Because a much larger portion of patients were admitted to the floor in the post-COVID period, much fewer patients had routine lab studies ordered after surgery (p=0.004). \u0026nbsp;Lastly, prior to the pandemic risk of complications was similar between ICU and floor patients. After the pandemic, patients admitted to the floor were much less likely to have a complication p=0.004. (\u003cstrong\u003eTable 5\u003c/strong\u003e).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMultivariable logistic regression analysis revealed no significant association between admission location, CCI, surgery recurrence, diagnosis, and surgery length on the odds of developing complications\u0026nbsp;\u003cstrong\u003e(Table 6).\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e"},{"header":"Discussion ","content":"\u003cp\u003eThe ICU is an invaluable resource that is necessary to provide patients with highly specialized life-saving care. While admission to the ICU may be warranted for critical patients after surgery, the change in admission practices necessitated by the COVID-19 pandemic required surgeons at our institution to be more thoughtful about which patients should be admitted to the ICU following craniotomy for supratentorial tumor. The results of this study are consistent with other reports in the literature where specific protocols have been developed to admit patients to an ICU step-down unit or the general postoperative neurosurgery floor rather than the ICU.\u003csup\u003e7,9,10,18,19\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAdmission to an ICU step-down unit provides patients with an intermediate level of care between that of the ICU and the floor. For example, Young et al.\u003csup\u003e10\u003c/sup\u003e developed a \u0026ldquo;Safe Transitions Pathway\u0026rdquo; model in which select patients were admitted to an ICU step-down unit rather than the ICU after craniotomy. Patients were included in the Safe Transitions Pathway model if they were under the age of 65, had a supratentorial tumor size \u0026lt; 3 cm, case length \u0026lt; 6 hours, and estimated blood loss \u0026lt; 500mL.\u003csup\u003e10\u003c/sup\u003e Patients in the Safe Transitions Pathway group were found to have significantly decreased LOS and direct cost per case by approximately $422,000.\u003csup\u003e10\u003c/sup\u003e No patients were upgraded to the ICU, returned to the operating room, or died within the study time frame.\u003csup\u003e10\u003c/sup\u003e A later study by Laan et al.\u003csup\u003e23\u003c/sup\u003e implemented a \u0026ldquo;no ICU, unless\u0026rdquo; policy to compare outcomes following supratentorial craniotomy when admitted to the ICU or ICU step-down unit. The implementation of this policy was found to provide a 13.3% reduction in cost for patients and significantly reduced postoperative complications without increasing LOS.\u003csup\u003e23\u003c/sup\u003e Patients included in this protocol were interviewed after discharge and reported feeling safe and at ease while admitted to the ICU step-down unit.\u003csup\u003e23\u003c/sup\u003e Perez-Varga et al.\u003csup\u003e7\u003c/sup\u003e developed an ICU step-down unit specifically for craniotomy for tumor patients during the COVID-19 pandemic. Patients were admitted to this intermediate unit if they were found to have no immediate postoperative complications, no signs and symptoms of clinical deterioration, no intracranial pressure monitors, no external ventricular drain, and no use of vasopressors.\u003csup\u003e7\u003c/sup\u003e Patients in this cohort experienced no adverse outcomes with significant financial savings.\u003csup\u003e7\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003eThe safety of ICU step-down admission led several investigators to compare outcomes following admission to the general floor as compared to the ICU. Florman et al.\u003csup\u003e18\u003c/sup\u003e admitted supratentorial craniotomy for tumor patients to the neurosurgery floor rather than the ICU if they were hemodynamically stable with no new postoperative neurologic impairment. The floor admission protocol was created in a multidisciplinary manner based on historical patient outcomes with oversight by all practicing neurosurgeons, neurointensivists, nursing, and the neuro-surgical physical extender group.\u003csup\u003e18\u003c/sup\u003e The results of this study found that patients sent to the floor had significantly shorter LOS and length of surgery with significantly more patients being discharged home.\u003csup\u003e18\u003c/sup\u003e A postoperative post-anesthesia care unit pathway developed by Hoffman et al.\u003csup\u003e9\u003c/sup\u003e was found to significantly reduce LOS in craniotomy for tumor patients treated from January 2021 to January 2022 with no increased risk of early hospital readmission. Patients with case lengths of \u0026lt; 5 hours and estimated blood loss \u0026lt; 500mL were admitted to the floor using this protocol.\u003csup\u003e9\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eUltimately, the level of postoperative care provided to an individual patient should depend on their unique presentation. Previous studies have indicated that craniotomy patients should be admitted to the ICU if they experience hemodynamic instability, severe neurologic complications, significant blood loss, low blood oxygen after extubation, a need for postoperative insulin drip, or duration of surgery longer than six hours.\u003csup\u003e23-25\u003c/sup\u003e Franko et al.\u003csup\u003e26\u003c/sup\u003e observed that less than 10% of supratentorial craniotomy for tumor patients require ICU-level care and developed a 4-point score to guide ICU admission decisions. This score includes a Karnofsky Performance Status less than 70 (1 point), need for general endotracheal anesthesia (1 point), and development of postoperative complications (2 points). The authors of this study found that a greater 4-point prediction score increased the likelihood of requiring ICU-specific care, indicating the use of this 4-point score may aid clinicians in stratifying the need for ICU admission in resource-limited settings. Based on our analysis, patients admitted to the ICU from 2021 to 2023 were more likely to have a higher CCI as compared to patients admitted to the general floor. Implementing a more personalized ICU admission protocol based on specific postoperative criteria and individual patient comorbidities ensures that ICU resources are allocated to the most critical patients, allowing for improved patient outcomes. This approach could additionally lead to a more efficient system that significantly reduces patient costs and unnecessary use of ICU resources.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe present study is unique in the sense that our change in practice of admitting patients to the neurosurgery floor rather than the ICU was sudden and in absence of a formal enhanced recovery after surgery protocol. Patients admitted to the ICU and neurosurgical floor prior to the pandemic were similar with respect to CCI, LOS, and postoperative complications. Following the change in practices brought about by the COVID-19 pandemic, our population of patients admitted to the ICU following craniotomy for tumor were more complicated, as indicated by the higher CCI than those admitted to the floor. The increased number of unique postoperative complications following this change in practice for ICU patients may be a direct reflection of this higher complexity of patients, as more critical patients are at a greater risk of developing postoperative complications by nature. The downward trend in 30-day readmission rates for patients admitted to the floor pre-COVID-19 as compared to post-COVID-19 suggests that lower-risk patients were appropriately triaged to the floor rather than the ICU, further supporting this idea. We found this shift in practice patterns to be safe, thus, our decision-making algorithm of sending more critical patients to the ICU and less critical patients to the neurosurgery floor following supratentorial craniotomy for tumor resection was both safe and effective. This finding highlights how admission to the ICU may not be necessary in all cases for safe and successful recovery following supratentorial craniotomy for tumor resection.\u003c/p\u003e\n\u003cp\u003eThe limitations of this study include that all patient data were collected from a single surgeon at a single institution, which may have influenced the case distribution and surgical decision-making. The exclusion of other tumors outside of the supratentorial region may introduce selection bias and fail to represent the broader population of all craniotomy patients, although this was done intentionally to limit the confounders that may come with tumors in other locations (i.e. ventriculostomy). Future research efforts should be conducted to analyze data across a variety of neurosurgical pathologies, surgeons, and procedures to improve the validity of this study.\u0026nbsp;\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eAt our institution, postoperative admission to the neurosurgery floor for supratentorial craniotomy significantly reduced LOS without increased readmissions. Use of ICU beds can be reserved for critically ill patients while reducing LOS of post-craniotomy patients by sending them to the floor after surgery.\u0026nbsp;\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eCCI\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eCharlson Comorbidity Index\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eDVT\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eDeep vein thrombosis\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eERAS\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eEnhanced Recovery After Surgery\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eICU\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eIntensive Care Unit\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eLOS\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eLength of Stay\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eOR\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eOdds Ratio\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eSD\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eStandard Deviation\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eRequired Research Reporting Guidelines\u003c/strong\u003e: None\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of Interest\u003c/strong\u003e: None\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDisclosure of Funding\u003c/strong\u003e: No funding was obtained for this work\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eHuman Ethics and Consent to Participate declarations:\u003c/strong\u003e Not applicable\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eAuthor Contributions:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eGH: Drafting of original manuscript, revision of manuscript, data collection\u003c/p\u003e\n\u003cp\u003eRM: Drafting of original manuscript, revision of manuscript\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eGL: Drafting of original manuscript, data analysis\u003c/p\u003e\n\u003cp\u003eGE: Data collection\u003c/p\u003e\n\u003cp\u003eKM: Data collection\u003c/p\u003e\n\u003cp\u003eAM: Data collection\u003c/p\u003e\n\u003cp\u003eGP: Data collection\u003c/p\u003e\n\u003cp\u003eJL: Revision of manuscript\u003c/p\u003e\n\u003cp\u003eAD: Revision of manuscript, data collection\u003c/p\u003e\n\u003cp\u003eMR: Project oversight, revision of manuscript, primary surgeon\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eWhitmore RG, Thawani JP, Grady MS, Levine JM, Sanborn MR, Stein SC. Is aggressive treatment of traumatic brain injury cost-effective? \u003cem\u003eJournal of Neurosurgery\u003c/em\u003e. 2012;116(5):1106-1113. doi:10.3171/2012.1.Jns11962\u003c/li\u003e\n\u003cli\u003eStein SC, Georgoff P, Meghan S, Mirza KL, El Falaky OM. Relationship of aggressive monitoring and treatment to improved outcomes in severe traumatic brain injury. \u003cem\u003eJournal of Neurosurgery\u003c/em\u003e. 2010;112(5):1105-1112. doi:10.3171/2009.8.Jns09738\u003c/li\u003e\n\u003cli\u003eTripathi S, Kim M. Outcome Differences Between Direct Admissions to the PICU From ED and Escalations From Floor. \u003cem\u003eHospital Pediatrics\u003c/em\u003e. 2021;11(11):1237-1249. doi:10.1542/hpeds.2020-005769\u003c/li\u003e\n\u003cli\u003eRubano JA, Vosswinkel JA, McCormack JE, Huang EC, Shapiro MJ, Jawa RS. 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Dec 2023;7(6):534-543. doi:10.1016/j.mayocpiqo.2023.09.002\u003c/li\u003e\n\u003cli\u003eBeauregard CL, Friedman WA. Routine use of postoperative ICU care for elective craniotomy: a cost-benefit analysis. \u003cem\u003eSurgical Neurology\u003c/em\u003e. 2003;60(6):483-489. doi:10.1016/s0090-3019(03)00517-2\u003c/li\u003e\n\u003cli\u003eHoffman SE, Gupta S, O\u0026apos;Connor M, et al. Reduced time to imaging, length of stay, and hospital charges following implementation of a novel postoperative pathway for craniotomy. \u003cem\u003eJ Neurosurg\u003c/em\u003e. Aug 1 2023;139(2):373-384. doi:10.3171/2022.12.JNS222123\u003c/li\u003e\n\u003cli\u003eYoung JS, Chan AK, Viner JA, et al. A Safe Transitions Pathway for post-craniotomy neurological surgery patients: high-value care that bypasses the intensive care unit. \u003cem\u003eJournal of Neurosurgery\u003c/em\u003e. 2021;134(5):1386-1391. doi:10.3171/2020.3.Jns192133\u003c/li\u003e\n\u003cli\u003eDieteren CM, van Hulsen MAJ, Rohde KIM, van Exel J. How should ICU beds be allocated during a crisis? Evidence from the COVID-19 pandemic. \u003cem\u003ePLoS One\u003c/em\u003e. 2022;17(8):e0270996. doi:10.1371/journal.pone.0270996\u003c/li\u003e\n\u003cli\u003eVranas KC, Golden SE, Mathews KS, et al. The Influence of the COVID-19 Pandemic on ICU Organization, Care Processes, and Frontline Clinician Experiences: A Qualitative Study. \u003cem\u003eChest\u003c/em\u003e. Nov 2021;160(5):1714-1728. doi:10.1016/j.chest.2021.05.041\u003c/li\u003e\n\u003cli\u003eArabi YM, Azoulay E, Al-Dorzi HM, et al. How the COVID-19 pandemic will change the future of critical care. \u003cem\u003eIntensive Care Med\u003c/em\u003e. Mar 2021;47(3):282-291. doi:10.1007/s00134-021-06352-y\u003c/li\u003e\n\u003cli\u003eReihl SJ, Garcia JH, Morshed RA, et al. Impact of the COVID-19 Pandemic on Neurosurgical Transfers: A Single Tertiary Center Study. \u003cem\u003eWorld Neurosurgery\u003c/em\u003e. 2022;166:e915-e923. doi:10.1016/j.wneu.2022.07.137\u003c/li\u003e\n\u003cli\u003eDeldar R, Abu El Hawa AA, Gupta N, et al. Intensive care unit versus floor admission following lower extremity free flap surgery: Is there a difference in outcomes? \u003cem\u003eMicrosurgery\u003c/em\u003e. 2022;42(7):696-702. doi:10.1002/micr.30935\u003c/li\u003e\n\u003cli\u003eMallari RJ, Avery MB, Corlin A, et al. Streamlining brain tumor surgery care during the COVID-19 pandemic: A case-control study. \u003cem\u003ePLoS One\u003c/em\u003e. 2021;16(7):e0254958. doi:10.1371/journal.pone.0254958\u003c/li\u003e\n\u003cli\u003eCharlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. \u003cem\u003eJ Chronic Dis\u003c/em\u003e. 1987;40(5):373-83. doi:10.1016/0021-9681(87)90171-8\u003c/li\u003e\n\u003cli\u003eFlorman JE, Cushing D, Keller LA, Rughani AI. A protocol for postoperative admission of elective craniotomy patients to a non-ICU or step-down setting. \u003cem\u003eJournal of Neurosurgery\u003c/em\u003e. 2017;127(6):1392-1397. doi:10.3171/2016.10.Jns16954\u003c/li\u003e\n\u003cli\u003eVeilleux TLR, Costa RS, Chalk G, et al. Post-Operative Craniotomy Pathway - PACU to Floor Pilot. \u003cem\u003eJournal of PeriAnesthesia Nursing\u003c/em\u003e. 2021;36(4):e6-e7. doi:10.1016/j.jopan.2021.06.025\u003c/li\u003e\n\u003cli\u003eHalme ALE, Roshanov PS, Tornberg SV, et al. Timing of Major Postoperative Bleeding Among Patients Undergoing Surgery. \u003cem\u003eJAMA Network Open\u003c/em\u003e. 2024;7(4)doi:10.1001/jamanetworkopen.2024.4581\u003c/li\u003e\n\u003cli\u003eBonde A, Varadarajan KM, Bonde N, et al. Assessing the utility of deep neural networks in predicting postoperative surgical complications: a retrospective study. \u003cem\u003eThe Lancet Digital Health\u003c/em\u003e. 2021;3(8):e471-e485. doi:10.1016/s2589-7500(21)00084-4\u003c/li\u003e\n\u003cli\u003eLonjaret L, Guyonnet M, Berard E, et al. Postoperative complications after craniotomy for brain tumor surgery. \u003cem\u003eAnaesthesia Critical Care \u0026amp; Pain Medicine\u003c/em\u003e. 2017;36(4):213-218. doi:10.1016/j.accpm.2016.06.012\u003c/li\u003e\n\u003cli\u003eLaan MT, Roelofs S, Van Huet I, Adang EMM, Bartels R. Selective Intensive Care Unit Admission After Adult Supratentorial Tumor Craniotomy: Complications, Length of Stay, and Costs. \u003cem\u003eNeurosurgery\u003c/em\u003e. Jan 1 2020;86(1):E54-E59. doi:10.1093/neuros/nyz388\u003c/li\u003e\n\u003cli\u003eHatipoglu Majernik G, Wolff Fernandes F, Al-Afif S, et al. Routine postoperative admission to the neurocritical intensive care unit after microvascular decompression: necessary or can it be abandoned? \u003cem\u003eNeurosurg Rev\u003c/em\u003e. Dec 9 2022;46(1):12. doi:10.1007/s10143-022-01910-4\u003c/li\u003e\n\u003cli\u003eRuiz Colon GD, Ohkuma R, Pendharkar AV, et al. A Protocol for Reducing Intensive Care Utilization After Craniotomy: A 3-Year Assessment. \u003cem\u003eNeurosurgery\u003c/em\u003e. May 1 2023;92(5):1080-1090. doi:10.1227/neu.0000000000002337\u003c/li\u003e\n\u003cli\u003eFranko LR, Hollon T, Linzey J, et al. Clinical Factors Associated With ICU-Specific Care Following Supratentoral Brain Tumor Resection and Validation of a Risk Prediction Score. \u003cem\u003eCrit Care Med\u003c/em\u003e. Aug 2018;46(8):1302-1308. doi:10.1097/CCM.0000000000003207\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"678\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 85.555%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 1 \u0026ndash; Demographic and Clinical Characteristics for All Patients by Admission Location (ICU vs. Neurosurgery Floor)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 20.854%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15.2395%;\"\u003e\n \u003cp\u003eOverall\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e(N = 327)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.5224%;\"\u003e\n \u003cp\u003eICU\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e(N = 249)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 16.8436%;\"\u003e\n \u003cp\u003eNeurosurgery Floor\u003c/p\u003e\n \u003cp\u003e(N = 78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.0416%;\"\u003e\n \u003cp\u003ep-value\u003csup\u003e+\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.854%;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.2395%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21.5224%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.8436%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.0416%;\"\u003e\n \u003cp\u003e0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.854%;\"\u003e\n \u003cp\u003e\u0026nbsp; Male\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15.2395%;\"\u003e\n \u003cp\u003e198 (60.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.5224%;\"\u003e\n \u003cp\u003e155 (62.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 16.8436%;\"\u003e\n \u003cp\u003e43 (55.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.0416%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.854%;\"\u003e\n \u003cp\u003e\u0026nbsp; Female\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15.2395%;\"\u003e\n \u003cp\u003e129 (39.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.5224%;\"\u003e\n \u003cp\u003e94 (37.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 16.8436%;\"\u003e\n \u003cp\u003e35 (44.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.0416%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.854%;\"\u003e\n \u003cp\u003eCCI\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.2395%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21.5224%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.8436%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.0416%;\"\u003e\n \u003cp\u003e0.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.854%;\"\u003e\n \u003cp\u003e\u0026nbsp; Mean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15.2395%;\"\u003e\n \u003cp\u003e4.2 (2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.5224%;\"\u003e\n \u003cp\u003e4.2 (2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 16.8436%;\"\u003e\n \u003cp\u003e4.0 (2.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.0416%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.854%;\"\u003e\n \u003cp\u003e\u0026nbsp; Median\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15.2395%;\"\u003e\n \u003cp\u003e4.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.5224%;\"\u003e\n \u003cp\u003e4.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 16.8436%;\"\u003e\n \u003cp\u003e3.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.0416%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.854%;\"\u003e\n \u003cp\u003e\u0026nbsp; Range\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15.2395%;\"\u003e\n \u003cp\u003e0.0 to 14.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.5224%;\"\u003e\n \u003cp\u003e0.0 to 14.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 16.8436%;\"\u003e\n \u003cp\u003e0.0 to 11.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.0416%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.854%;\"\u003e\n \u003cp\u003eDiagnosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15.2395%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.5224%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 16.8436%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.0416%;\"\u003e\n \u003cp\u003e0.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.854%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Glioma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15.2395%;\"\u003e\n \u003cp\u003e278 (85.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.5224%;\"\u003e\n \u003cp\u003e209 (83.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 16.8436%;\"\u003e\n \u003cp\u003e69 (88.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.0416%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.854%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Meningioma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15.2395%;\"\u003e\n \u003cp\u003e6 (1.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.5224%;\"\u003e\n \u003cp\u003e6 (2.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 16.8436%;\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.0416%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.854%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Metastatic lesion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15.2395%;\"\u003e\n \u003cp\u003e13 (4.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.5224%;\"\u003e\n \u003cp\u003e11 (4.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 16.8436%;\"\u003e\n \u003cp\u003e2 (2.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.0416%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.854%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Other\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15.2395%;\"\u003e\n \u003cp\u003e30 (9.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.5224%;\"\u003e\n \u003cp\u003e23 (9.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 16.8436%;\"\u003e\n \u003cp\u003e7 (9.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.0416%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.854%;\"\u003e\n \u003cp\u003eLength of surgery (hours)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15.2395%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.5224%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 16.8436%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.0416%;\"\u003e\n \u003cp\u003e0.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.854%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Mean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15.2395%;\"\u003e\n \u003cp\u003e3.1 (1.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.5224%;\"\u003e\n \u003cp\u003e3.0 (1.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 16.8436%;\"\u003e\n \u003cp\u003e3.4 (2.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.0416%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.854%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Median\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15.2395%;\"\u003e\n \u003cp\u003e2.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.5224%;\"\u003e\n \u003cp\u003e2.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 16.8436%;\"\u003e\n \u003cp\u003e3.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.0416%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.854%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Range\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15.2395%;\"\u003e\n \u003cp\u003e0.1 to 21.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.5224%;\"\u003e\n \u003cp\u003e0.1 to 10.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 16.8436%;\"\u003e\n \u003cp\u003e1.0 to 21.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.0416%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.854%;\"\u003e\n \u003cp\u003eLOS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15.2395%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.5224%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 16.8436%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.0416%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt; 0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.854%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Mean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15.2395%;\"\u003e\n \u003cp\u003e5.3 (6.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.5224%;\"\u003e\n \u003cp\u003e5.9 (6.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 16.8436%;\"\u003e\n \u003cp\u003e3.4 (3.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.0416%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.854%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Median\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15.2395%;\"\u003e\n \u003cp\u003e3.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.5224%;\"\u003e\n \u003cp\u003e4.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 16.8436%;\"\u003e\n \u003cp\u003e2.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.0416%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.854%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Range\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15.2395%;\"\u003e\n \u003cp\u003e0.0 to 68.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.5224%;\"\u003e\n \u003cp\u003e1.0 to 68.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 16.8436%;\"\u003e\n \u003cp\u003e0.0 to 22.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.0416%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.854%;\"\u003e\n \u003cp\u003eDisposition\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15.2395%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.5224%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 16.8436%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.0416%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt; 0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.854%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Home\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15.2395%;\"\u003e\n \u003cp\u003e226 (69.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.5224%;\"\u003e\n \u003cp\u003e157 (63.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 16.8436%;\"\u003e\n \u003cp\u003e69 (88.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.0416%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.854%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Skilled nursing home\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15.2395%;\"\u003e\n \u003cp\u003e2 (0.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.5224%;\"\u003e\n \u003cp\u003e2 (0.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 16.8436%;\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.0416%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.854%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;In-patient rehabilitation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15.2395%;\"\u003e\n \u003cp\u003e83 (25.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.5224%;\"\u003e\n \u003cp\u003e75 (30.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 16.8436%;\"\u003e\n \u003cp\u003e8 (10.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.0416%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.854%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Patient died\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15.2395%;\"\u003e\n \u003cp\u003e3 (0.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.5224%;\"\u003e\n \u003cp\u003e3 (1.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 16.8436%;\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.0416%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.854%;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Other*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15.2395%;\"\u003e\n \u003cp\u003e13 (4.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.5224%;\"\u003e\n \u003cp\u003e12 (4.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 16.8436%;\"\u003e\n \u003cp\u003e1 (1.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.0416%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.854%;\"\u003e\n \u003cp\u003eReadmission within 30 days of surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15.2395%;\"\u003e\n \u003cp\u003e55 (16.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.5224%;\"\u003e\n \u003cp\u003e42 (16.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 16.8436%;\"\u003e\n \u003cp\u003e13 (16.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.0416%;\"\u003e\n \u003cp\u003e\u0026gt; 0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.854%;\"\u003e\n \u003cp\u003eReturn to the operating room within 30 days of surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15.2395%;\"\u003e\n \u003cp\u003e45 (13.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.5224%;\"\u003e\n \u003cp\u003e39 (15.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 16.8436%;\"\u003e\n \u003cp\u003e6 (7.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.0416%;\"\u003e\n \u003cp\u003e0.090\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.854%;\"\u003e\n \u003cp\u003eMortality within 30 days of surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15.2395%;\"\u003e\n \u003cp\u003e9 (2.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.5224%;\"\u003e\n \u003cp\u003e9 (3.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 16.8436%;\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.0416%;\"\u003e\n \u003cp\u003e0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.854%;\"\u003e\n \u003cp\u003eTotal number of patients with complications during hospital stay\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15.2395%;\"\u003e\n \u003cp\u003e49 (15.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.5224%;\"\u003e\n \u003cp\u003e44 (18.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 16.8436%;\"\u003e\n \u003cp\u003e5 (6.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.0416%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.011\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.854%;\"\u003e\n \u003cp\u003eLaboratory values collected within 24 hours of surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15.2395%;\"\u003e\n \u003cp\u003e171 (53.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.5224%;\"\u003e\n \u003cp\u003e146 (60.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 16.8436%;\"\u003e\n \u003cp\u003e25 (32.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.0416%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt; 0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20.854%;\"\u003e\n \u003cp\u003ePostoperative edema\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 15.2395%;\"\u003e\n \u003cp\u003e167 (51.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 21.5224%;\"\u003e\n \u003cp\u003e121 (51.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 16.8436%;\"\u003e\n \u003cp\u003e46 (49.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.0416%;\"\u003e\n \u003cp\u003e0.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e*Diagnosis of \u0026ldquo;other\u0026rdquo; refers to patients who had a supratentorial tumor outside of the aforementioned defined diagnoses. Disposition of \u0026ldquo;other\u0026rdquo; refers to disposition outside of the aforementioned defined locations.\u003c/p\u003e\n\u003cp\u003e+P-values were calculated with a Fisher\u0026rsquo;s exact test or Wilcoxon rank sum test\u003c/p\u003e\n\u003cp\u003eCCI \u0026ndash; Charlson Comorbidity Index, ICU \u0026ndash; Intensive Care Unit, LOS \u0026ndash; Length of Hospital Stay, SD \u0026ndash; Standard Deviation,\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2 \u0026ndash;Complications During Hospital Stay by Admission Location (ICU vs. Neurosurgery Floor) for All Patients (2017-2019 and 2021-2023)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"642\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 84px;\"\u003e\n \u003cp\u003eOverall\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e(N = 327)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 126px;\"\u003e\n \u003cp\u003eICU\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e(N = 249)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 150px;\"\u003e\n \u003cp\u003eNeurosurgery Floor\u003c/p\u003e\n \u003cp\u003e(N = 78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 186px;\"\u003e\n \u003cp\u003eAcute respiratory failure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 84px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 126px;\"\u003e\n \u003cp\u003e4 (1.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 150px;\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e0.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 186px;\"\u003e\n \u003cp\u003eDeath\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 84px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 126px;\"\u003e\n \u003cp\u003e3 (1.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 150px;\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026gt; 0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 186px;\"\u003e\n \u003cp\u003eHematoma\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e6 (2.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e1 (1.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026gt;0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 186px;\"\u003e\n \u003cp\u003eInfection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 84px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 126px;\"\u003e\n \u003cp\u003e7 (2.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 150px;\"\u003e\n \u003cp\u003e2 (2.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026gt;0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 186px;\"\u003e\n \u003cp\u003eNew neurologic deficits\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 84px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 126px;\"\u003e\n \u003cp\u003e2 (0.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 150px;\"\u003e\n \u003cp\u003e1 (1.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e0.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 186px;\"\u003e\n \u003cp\u003eSeizure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 84px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 126px;\"\u003e\n \u003cp\u003e16 (6.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 150px;\"\u003e\n \u003cp\u003e3 (3.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e0.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 186px;\"\u003e\n \u003cp\u003eStroke\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 84px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 126px;\"\u003e\n \u003cp\u003e6 (2.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 150px;\"\u003e\n \u003cp\u003e1 (1.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026gt;0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 186px;\"\u003e\n \u003cp\u003eDVT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 84px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 126px;\"\u003e\n \u003cp\u003e2 (0.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 150px;\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026gt;0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eThe total number of complications for all patients in this study was extracted and analyzed. For patients with multiple complications, each complication was coded as a unique event. Values are reported as frequency (percent). P-values were calculated with a Fisher\u0026rsquo;s exact test. \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eDVT = Deep Vein Thrombosis; ICU = Intensive Care Unit\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3 \u0026ndash; Indications for ICU Upgrade from the Neurosurgery Floor Post-COVID-19 (2021-2023).\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"780\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge/Gender\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCCI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDiagnosis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePostoperative Admission Location\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 396px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIndication for ICU Upgrade\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e74-year-old male\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eGBM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003eNeurosurgery floor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 396px;\"\u003e\n \u003cp\u003eIntractable seizures\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e57-year-old male\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eGBM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003eICU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 396px;\"\u003e\n \u003cp\u003eOn postoperative day 9 and 10, the patient became progressively more confused and repeat MRI demonstrated significantly worsened edema, midline shift\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e63-year-old-male\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eAstrocytoma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003eNeurosurgery floor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 396px;\"\u003e\n \u003cp\u003ePatient spontaneously went into atrial fibrillation with rapid ventricular response while on the neurosurgery floor and was upgraded to the ICU the same night.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e74-year-old male\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eMeningioma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003eICU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 396px;\"\u003e\n \u003cp\u003eIntractable seizures\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e60-year-old-male\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eMetastatic melanoma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003eICU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 396px;\"\u003e\n \u003cp\u003eOn postoperative day 2 he experienced venous infarct requiring take back to the OR\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eOf the patients admitted to the neurosurgery floor for the entire study timeframe, 5 patients (5.4%) were upgraded from the neurosurgery floor to the ICU. Individual CCI, diagnosis, and indication for ICU upgrade from the neurosurgery floor is reported here.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eCCI \u0026ndash; Charleson Comorbidity Index; GBM \u0026ndash; Glioblastoma; ICU \u0026ndash; Intensive Care Unit; MRI \u0026ndash; Magnetic Resonance Imaging\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4 \u0026ndash; Demographic and Clinical Characteristics by Time Period (2017-2019: Pre-COVID vs. 2021-2023: Post-COVID) and Admission Location (ICU vs. Neurosurgery Floor)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"666\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 396px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;2017 \u0026ndash; 2019\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 270px;\"\u003e\n \u003cp\u003e2021 \u0026ndash; 2023\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 105px;\"\u003e\n \u003cp\u003eICU (N=127)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003eNeurosurgery Floor (N=8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003eICU (N=75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003eNeurosurgery Floor (N=69)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e0.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp; Male\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e80 (63.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e4 (50.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e45 (60.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e39 (56.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp; Female\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e47 (37.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e4 (50.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e30 (40.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e30 (43.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003eCCI\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e0.052\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp; Mean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e4.1 (2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e4.1 (1.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e4.5 (2.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e3.9 (2.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp; Median\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e4.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e3.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e4.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e3.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp; Range\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.0 to 13.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e2.0 to 7.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e2.0 to 14.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e0.0 to 11.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003eDiagnosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e0.091\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Glioma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e111 (87.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e7 (87.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e60 (80.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e61 (88.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Meningioma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e2 (1.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e3 (4.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Metastatic lesion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e3 (2.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e1 (12.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e6 (8.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e1 (1.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Other\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e11 (8.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e6 (6.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e7 (10.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003eLength of surgery (hours)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt; 0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e0.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Mean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e2.6 (1.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e1.4 (0.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e3.9 (1.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e3.7 (2.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Median\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e2.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e1.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e3.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e3.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Range\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0.5 to 5.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e1.2 to 2.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e1.4 to 8.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e1.0 to 21.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003eLOS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt; 0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Mean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e5.0 (3.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e3.8 (3.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e7.1 (9.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e3.4 (3.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Median\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e4.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e3.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e4.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e2.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Range\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e1.0 to 19.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e0.0 to 8.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e1.0 to 68.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e0.0 to 22.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003eDisposition\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Home\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e79 (62.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e6 (75%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e48 (64.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e62 (89.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; Skilled nursing \u0026nbsp;home\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e1 (0.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e1 (1.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;In-patient \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; rehabilitation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e41 (32.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e1 (12.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e21 (28.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e7 (10.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Patient died\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e1 (0.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e2 (2.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Other\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e5 (3.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e1 (12.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e3 (4.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003eReadmission within 30 days of surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e16 (12.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e3 (37.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.084\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e15 (20.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e10 (14.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e0.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003eReturn to operating room within 30 days of surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e12 (9.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026gt; 0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e13 (17.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e6 (8.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e0.15\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003eMortality within 30 days of surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e3 (2.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026gt; 0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e5 (6.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e0.059\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003eTotal number of patients with complications during hospital stay\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e20 (16.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e1 (12.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026gt; 0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e15 (20.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e4 (5.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.012\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003eLaboratory values collected within 24 hours of surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e73 (58.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e2 (25.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.076\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e42 (58.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e23 (33.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.004\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003ePostoperative edema\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e59 (50.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e9 (47.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026gt; 0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e34 (45.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003e34 (49.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e0.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003ePatients treated in the year 2020 were excluded from this analysis because 2020 served as a washout period. Diagnosis of \u0026ldquo;other\u0026rdquo; refers to patients who had a supratentorial tumor outside of the aforementioned defined diagnoses. Disposition of \u0026ldquo;other\u0026rdquo; refers to disposition outside of the aforementioned defined locations. P-values were calculated with a Fisher\u0026rsquo;s exact test or Wilcoxon rank sum test\u003c/p\u003e\n\u003cp\u003eCCI \u0026ndash; Charlson Comorbidity Index, ICU \u0026ndash; Intensive Care Unit, LOS \u0026ndash; Length of Hospital Stay, SD \u0026ndash; Standard Deviation\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5 \u0026ndash; Complications During Hospital Stay for Patients by\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eTime Period (2017-2019: Pre-COVID vs. 2021-2023: Post-COVID) and Admission Location (ICU vs. Neurosurgery Floor)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"690\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 431px;\"\u003e\n \u003cp\u003e2017 - 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 259px;\"\u003e\n \u003cp\u003e2021 - 2023\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 164px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003eICU (N=127)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eNeurosurgery Floor (N=8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003eICU (N=75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003eNeurosurgery Floor (N=69)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 164px;\"\u003e\n \u003cp\u003eAcute respiratory failure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e2 (1.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e\u0026gt;0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e1 (1.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026gt;0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 164px;\"\u003e\n \u003cp\u003eDeath\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e1 (0.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e\u0026gt;0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e2 (2.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 164px;\"\u003e\n \u003cp\u003eHematoma\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e2 (1.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e\u0026gt;0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e3 (4.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e1 (1.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 164px;\"\u003e\n \u003cp\u003eInfection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e2 (1.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e\u0026gt;0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e1 (1.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e2 (2.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 164px;\"\u003e\n \u003cp\u003eNew neurologic deficits\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e1 (0.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e\u0026gt;0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e1 (1.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 164px;\"\u003e\n \u003cp\u003eSeizure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e7 (5.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1 (12.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e0.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e9 (12.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e2 (2.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.058\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 164px;\"\u003e\n \u003cp\u003eStroke\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e5 (3.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e\u0026gt;0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e1 (1.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026gt;0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 164px;\"\u003e\n \u003cp\u003eDVT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e2 (2.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eThe total number of complications for all patients in this study were extracted and analyzed with respect to time period and admission location. For patients with multiple complications, each complication was coded as a unique event. Values are reported as frequency (percent). P-values were calculated with a Fisher\u0026rsquo;s exact test.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eDVT = Deep Vein Thrombosis; ICU = Intensive Care Unit\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 6 - Multivariable Logistic Regression Model of Complications (Yes vs. No) for All Patients (2017-2019 and 2021-2023)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 154px;\"\u003e\n \u003cp\u003eOdds Ratio\u003c/p\u003e\n \u003cp\u003e(OR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 154px;\"\u003e\n \u003cp\u003e95% Confidence Interval\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eNeurosurgery floor admission location (ref: ICU)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 154px;\"\u003e\n \u003cp\u003e0.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 154px;\"\u003e\n \u003cp\u003e0.39, 1.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e\n \u003cp\u003e0.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eSex (ref: Male)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 154px;\"\u003e\n \u003cp\u003e0.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 154px;\"\u003e\n \u003cp\u003e0.40, 1.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e\n \u003cp\u003e0.090\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eCCI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 154px;\"\u003e\n \u003cp\u003e1.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 154px;\"\u003e\n \u003cp\u003e0.93, 1.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e\n \u003cp\u003e0.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eRecurrent surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 154px;\"\u003e\n \u003cp\u003e1.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 154px;\"\u003e\n \u003cp\u003e0.53, 1.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e\n \u003cp\u003e\u0026gt;0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eDiagnosis (ref: Glioma)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 154px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 154px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Meningioma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 154px;\"\u003e\n \u003cp\u003e2.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 154px;\"\u003e\n \u003cp\u003e0.50, 20.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e\n \u003cp\u003e0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Metastatic lesion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 154px;\"\u003e\n \u003cp\u003e0.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 154px;\"\u003e\n \u003cp\u003e0.09, 1.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e\n \u003cp\u003e0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Other\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 154px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 154px;\"\u003e\n \u003cp\u003e0.43, 2.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e\n \u003cp\u003e\u0026gt;0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eSurgery length (hours)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 154px;\"\u003e\n \u003cp\u003e1.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 154px;\"\u003e\n \u003cp\u003e0.90, 1.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e\n \u003cp\u003e0.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eLaboratory values collected within 24 hours of surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 154px;\"\u003e\n \u003cp\u003e1.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 154px;\"\u003e\n \u003cp\u003e0.83, 2.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e\n \u003cp\u003e0.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eCCI \u0026ndash; Charlson Comorbidity Index\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 7 - Multivariable Logistic Regression Model of Complications (Yes vs. No) by Time Period (2017-2019: Pre-COVID vs. 2021-2023: Post-COVID)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"672\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 162px;\"\u003e\n \u003cp\u003eOdds Ratio (OR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 168px;\"\u003e\n \u003cp\u003e95% Confidence Interval\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003ePre-COVID-19 neurosurgery floor admission location (ref: ICU)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003e1.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 168px;\"\u003e\n \u003cp\u003e0.43, 8.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e0.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 186px;\"\u003e\n \u003cp\u003ePost-COVID-19 neurosurgery floor admission location (ref: ICU)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003e0.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 168px;\"\u003e\n \u003cp\u003e0.21, 0.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.013\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"ICU, neurosurgery floor, supratentorial craniotomy, outcomes, COVID","lastPublishedDoi":"10.21203/rs.3.rs-7012809/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7012809/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eIntroduction: \u003c/strong\u003eCraniotomy for tumor resection traditionally involves admission to the intensive care unit (ICU) for postoperative monitoring. During the COVID-19 epidemic, all patients who underwent uncomplicated craniotomy for tumor resection were admitted to a regular med-surg floor allowing ICU beds to be reserved for critically ill patients. The objective of this study was to evaluate the safety of this approach and its impact on length of stay (LOS).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eA retrospective chart review was conducted on adult patients receiving supratentorial craniotomy for resection of glioma, meningioma, or a metastatic lesion(s), between January 2017 and October 2023 by a single surgeon at our institution. Medical records were reviewed to assess postoperative admission location and complications, which were compared across pre-COVID-19 (2017-2019) and post-COVID-19 (2021-2023) time periods. Comparisons were evaluated by Fisher’s exact test, Wilcoxon rank sum test, and multivariable logistic regression models.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003ePre-COVID-19, 6% of patients (n = 8) were admitted to the neurosurgery floor whereas 48% of patients (n = 69) were admitted to the floor postop post-COVID-19. Patient demographics, tumor type, tumor location, and Charlson Comorbidity Index (CCI) were similar across both time periods, indicating comparable patient characteristics in the pre-COVID and post-COVID cohorts. Pre-COVID-19 patients admitted to the floor had a trend for reduced LOS (mean (SD): 3.8 (3.2) vs. 5.0 (3.9), p = 0.3) and fewer postoperative complications (12.5% vs. 58.9%, p\u0026gt;0.9). Post-COVID-19, these trends became more statistically significant as the number of patients admitted to the floor, and power, increased. Patients admitted to the floor in the post-COVID-19 era had significantly reduced LOS (3.4 (SD 3.5) vs. 7.1 (SD 9.1) for ICU patients, p\u0026lt;0.001). 30-day readmission rates for patients admitted to the floor demonstrated a decreased trend from pre- to post-COVID-19 (37.5% vs. 14.5%)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eAt our institution, postoperative admission to the neurosurgery floor for supratentorial craniotomy significantly reduced LOS without increased readmissions. Use of ICU beds can be reserved for critically ill patients while reducing LOS of post-craniotomy patients by sending them to the floor after surgery.\u003c/p\u003e","manuscriptTitle":"Evaluating Patient Outcomes of Postoperative Admission to the Neurosurgery Floor compared to the Intensive Care Unit Following Supratentorial Craniotomy for Brain Tumor Resection","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-15 08:36:58","doi":"10.21203/rs.3.rs-7012809/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"15884cfa-3766-450b-815f-98eba69206c6","owner":[],"postedDate":"July 15th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-11-07T07:23:44+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-15 08:36:58","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7012809","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7012809","identity":"rs-7012809","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}