title: Same-day discharge after craniotomy for supratentorial tumour surgery: a retrospective observational single-centre study.
abstract: OBJECTIVE
  Enhanced Recovery After Surgery is a multimodal perioperative care pathway designed to achieve early discharge in patients undergoing major surgery. Recent advances in neurosurgery allow for shorter duration of anesthesia and surgery, faster recovery, and earlier discharge from hospital. The purpose of this retrospective observational study was to assess the incidence of early discharge from hospital in patients undergoing craniotomy for supratentorial brain tumours as well as to explore the associated perioperative factors, anesthesia techniques, and complications.
  
  
  METHODS
  The medical records of all patients who underwent craniotomy (less than four-hour duration) for supratentorial tumour over a five-year period were retrospectively reviewed. The data analyzed included the postoperative discharge destination, type of anesthesia-i.e., general anesthesia (GA) vs awake craniotomy (AC), and the incidence of adverse events.
  
  
  RESULTS
  Data from 329 patients [mean (SD) age 48 (12) yr; 164 male, 165 female] were analyzed, including 198 (AC, n = 157; GA, n = 41) patients who were preoperatively scheduled for same-day discharge. Successful same-day discharge occurred in 175/198 (88.4%) of these patients (AC, n = 139; GA, n = 36). Five (2.9%) of the 175 patients (4 AC, 1 GA) with same-day discharge required readmission to hospital within the first 12 hr after discharge. Six (1.8%) of the 329 total patients had a documented postoperative intracranial bleed, but none occurred after initial discharge from hospital.
  
  
  CONCLUSIONS
  Same-day discharge from hospital is possible in carefully selected patients after both GA and AC for supratentorial tumour surgery.
authors: Department of Anesthesia and Pain Management, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada. lashmi.venkatraghavan@uhn.on.ca.|Department of Anesthesia, Toronto Western Hospital, University Health Network, University of Toronto, 399 Bathurst St, Toronto, ON, M5T 2S8, Canada. lashmi.venkatraghavan@uhn.on.ca.
authors: Lashmi
authors: http://orcid.org/0000-0002-1506-7000
authors: L
authors: Venkatraghavan
authors: Department of Anesthesia and Pain Management, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada.
authors: Suparna
authors: S
authors: Bharadwaj
authors: Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada.
authors: Karolyn
authors: K
authors: Au
authors: Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada.
authors: Mark
authors: M
authors: Bernstein
authors: Department of Anesthesia and Pain Management, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada.
authors: Pirjo
authors: P
authors: Manninen
mesh_terms: D000328:Adult; D000368:Aged; D000768:Anesthesia, General; D003399:Craniotomy / Q000009:adverse effects / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010351:Patient Discharge / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data; D018579:Patient Selection; D019990:Perioperative Care; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D015173:Supratentorial Neoplasms / Q000601:surgery*; D016896:Treatment Outcome; D014851:Wakefulness