title: Postoperative complications after craniotomy for brain tumor surgery.
abstract: BACKGROUND
  After elective craniotomy for brain tumour surgery, patients are usually admitted to an intensive care unit (ICU) for monitoring. Our goal was to evaluate the incidence and timing of neurologic and non-neurologic postoperative complications after brain tumour surgery, to determine factors associated with neurologic events and to evaluate the timing and causes of ICU readmission.
  
  
  METHODS
  This prospective, observational and analytic study enrolled 188 patients admitted to the ICU after brain tumour surgery. All postoperative clinical events during the first 24hours were noted and classified. Readmission causes and timing were also analysed.
  
  
  RESULTS
  Twenty-one (11%) of the patients were kept sedated after surgery; the remaining 167 patients were studied. Thirty one percent of the patients presented at least one complication (25% with postoperative nausea and vomiting (PONV), 16% with neurologic complications). The occurrence of neurological complications was significantly associated with the absence of preoperative motor deficit and the presence of higher intraoperative bleeding. Seven patients (4%) were readmitted to the ICU after discharge; 43% (n=3) of them had a posterior fossa surgery.
  
  
  CONCLUSIONS
  Postoperative complications, especially PONV, are frequent after brain tumour surgery. Moreover, 16% of patients presented a neurological complication, probably justifying the ICU postoperative stay for early detection. The absence of preoperative motor deficit and intraoperative bleeding seems to predict postoperative neurologic complications. Finally, patients may present complications after ICU discharge, especially patients with fossa posterior surgery, suggesting that ICU hospitalization may be longer in this type of surgery.
authors.affiliation: Department of Anesthesiology and Intensive Care, University Hospital of Toulouse, University Toulouse 3-Paul-Sabatier, Toulouse, France. Electronic address: laurent.lonjaret@laposte.net.
authors.forename: Laurent
authors.initials: L
authors.lastname: Lonjaret
authors.affiliation: Department of Anesthesiology and Intensive Care, University Hospital of Toulouse, University Toulouse 3-Paul-Sabatier, Toulouse, France. Electronic address: marineguyonnet.83@hotmail.fr.
authors.forename: Marine
authors.initials: M
authors.lastname: Guyonnet
authors.affiliation: Department of Epidemiology, HealthEconomics and public health, UMR-1027 Inserm, Toulouse University Hospital, Toulouse, France. Electronic address: emilie.berard@univ-tlse3.fr.
authors.forename: Emilie
authors.initials: E
authors.lastname: Berard
authors.affiliation: Department of Anesthesiology and Intensive Care, University Hospital of Toulouse, University Toulouse 3-Paul-Sabatier, Toulouse, France. Electronic address: vironneau.m@chu-toulouse.fr.
authors.forename: Marc
authors.initials: M
authors.lastname: Vironneau
authors.affiliation: Department of Anesthesiology and Intensive Care, University Hospital of Toulouse, University Toulouse 3-Paul-Sabatier, Toulouse, France. Electronic address: peres.f@chu-toulouse.fr.
authors.forename: Françoise
authors.initials: F
authors.lastname: Peres
authors.affiliation: Department of Anesthesiology and Intensive Care, University Hospital of Toulouse, University Toulouse 3-Paul-Sabatier, Toulouse, France. Electronic address: sacrista.s@chu-toulouse.fr.
authors.forename: Sandrine
authors.initials: S
authors.lastname: Sacrista
authors.affiliation: Department of Anesthesiology and Intensive Care, University Hospital of Toulouse, University Toulouse 3-Paul-Sabatier, Toulouse, France. Electronic address: ferrier-lewis.a@chu-toulouse.fr.
authors.forename: Anne
authors.initials: A
authors.lastname: Ferrier
authors.affiliation: Department of Anesthesiology and Intensive Care, University Hospital of Toulouse, University Toulouse 3-Paul-Sabatier, Toulouse, France. Electronic address: ramonda.v@chu-toulouse.fr.
authors.forename: Véronique
authors.initials: V
authors.lastname: Ramonda
authors.affiliation: Department of Anesthesiology and Intensive Care, University Hospital of Toulouse, University Toulouse 3-Paul-Sabatier, Toulouse, France. Electronic address: vuillaume.c@chu-toulouse.fr.
authors.forename: Corine
authors.initials: C
authors.lastname: Vuillaume
authors.affiliation: Department of Neurosurgery, University Hospital of Toulouse, University Toulouse 3-Paul-Sabatier, Toulouse, France. Electronic address: roux.fe@chu-toulouse.fr.
authors.forename: Franck-Emmanuel
authors.initials: FE
authors.lastname: Roux
authors.affiliation: Department of Anesthesiology and Intensive Care, University Hospital of Toulouse, University Toulouse 3-Paul-Sabatier, Toulouse, France. Electronic address: fourcade.o@chu-toulouse.fr.
authors.forename: Olivier
authors.initials: O
authors.lastname: Fourcade
authors.affiliation: Department of Anesthesiology and Intensive Care, University Hospital of Toulouse, University Toulouse 3-Paul-Sabatier, Toulouse, France. Electronic address: geeraerts.t@chu-toulouse.fr.
authors.forename: Thomas
authors.initials: T
authors.lastname: Geeraerts
mesh_terms: D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D001932:Brain Neoplasms / Q000401:mortality / Q000601:surgery*; D003388:Cranial Fossa, Posterior / Q000601:surgery; D003399:Craniotomy / Q000009:adverse effects* / Q000401:mortality; D003422:Critical Care; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000453:epidemiology / Q000209:etiology; D009422:Nervous System Diseases / Q000209:etiology / Q000628:therapy; D010359:Patient Readmission; D011183:Postoperative Complications / Q000401:mortality / Q000628:therapy*; D020250:Postoperative Nausea and Vomiting / Q000628:therapy; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors
keywords: Brain tumour surgery; ICU admission; Neurologic complication; PONV; Postoperative complication