title: [Diagnostic yield and postoperative management of patients submitted to brain biopsy in a university hospital].
abstract: OBJECTIVE
  To assess the diagnostic yield and the incidence of perioperative complications in patients undergoing an open or closed cerebral biopsy and to determine the length of intensive care monitoring, for early diagnosis and fast management of perioperative complications.
  
  
  METHODS
  This was a retrospective analysis of all the patients that underwent brain biopsy between January 2006 and July 2012. We recorded demographic data, comorbidities, modality of biopsy, intraoperative clinical data, histological results, computed tomography scanning findings and occurrence, and type of perioperative complications and moment of appearance.
  
  
  RESULTS
  Seventy-six brain biopsies in 75 consecutive patients (51 closed and 25 open) were analysed. Diagnostic yield was 98% for closed biopsies and 96% for open biopsies. Mortality related to the procedures was 3.9 and 4%, respectively. The incidence of major complications was 3.9% for closed biopsies and 8% for open biopsies; half of these appeared within the first 24 postoperative hours, during patient stay in the Intensive Care Unit. Age was the only risk factor for complications (P=.04) in our study. No differences in morbimortality were found between the studied groups.
  
  
  CONCLUSIONS
  Diagnostic yield was very high in our series. Because the importance of early diagnosis of complications for preventing long-term sequelae, we recommend overnight hospital stay for observation after open or closed brain biopsy.
authors.affiliation: Servicio de Anestesiología, Hospital Clínic, Barcelona, España.
authors.forename: Isabel
authors.initials: I
authors.lastname: Gracia
authors.affiliation: Servicio de Anestesiología, Hospital Clínic, Barcelona, España.
authors.forename: Laura
authors.initials: L
authors.lastname: Perelló
authors.affiliation: Servicio de Anestesiología, Hospital Clínic, Barcelona, España.
authors.forename: Ricard
authors.initials: R
authors.lastname: Valero
authors.affiliation: Servicio de Anestesiología, Hospital Clínic, Barcelona, España.
authors.forename: Adriana
authors.initials: A
authors.lastname: Hervías
authors.affiliation: Servicio de Anestesiología, Hospital Clínic, Barcelona, España.
authors.forename: Juan
authors.initials: J
authors.lastname: Perdomo
authors.affiliation: Servicio de Anestesiología, Hospital Clínic, Barcelona, España.
authors.forename: Roger
authors.initials: R
authors.lastname: Pujol
authors.affiliation: Servicio de Neurocirugía, Hospital Clínic, Barcelona, España.
authors.forename: Josep
authors.initials: J
authors.lastname: González
authors.affiliation: Servicio de Anestesiología, Hospital Clínic, Barcelona, España.
authors.forename: Paola
authors.initials: P
authors.lastname: Hurtado
authors.affiliation: Servicio de Anestesiología, Hospital Clínic, Barcelona, España.
authors.forename: Nicolás
authors.initials: N
authors.lastname: de Riva
authors.affiliation: Servicio de Anestesiología, Hospital Clínic, Barcelona, España.
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Tercero
authors.affiliation: Servicio de Anestesiología, Hospital Clínic, Barcelona, España.
authors.forename: Enrique
authors.initials: E
authors.lastname: Carrero
authors.affiliation: Servicio de Neurocirugía, Hospital Clínic, Barcelona, España.
authors.forename: Enric
authors.initials: E
authors.lastname: Ferrer
authors.affiliation: Servicio de Anestesiología, Hospital Clínic, Barcelona, España. Electronic address: fabregas@clinic.ub.es.
authors.forename: Neus
authors.initials: N
authors.lastname: Fàbregas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D001921:Brain / Q000473:pathology*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011183:Postoperative Complications / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
keywords: Anaesthesia; Anestesia; Biopsia cerebral cerrada; Closed brain biopsy; Complicaciones posoperatorias; Craneotomía; Craniotomy; Cuidados perioperatorios; Overnight intensive care; Perioperative care; Postoperative complications; Vigilancia posoperatoria monitorizada