{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T07:40:05Z","timestamp":1782546005784,"version":"3.54.5"},"reference-count":8,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2020,9,1]],"date-time":"2020-09-01T00:00:00Z","timestamp":1598918400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,9,1]],"date-time":"2020-09-01T00:00:00Z","timestamp":1598918400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"VGZ","award":["n\/a"],"award-info":[{"award-number":["n\/a"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Acta Neurochir"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Even though the need has been challenged, admitting patients to an intensive care or medium care unit (ICU\/MCU) after adult supratentorial tumor craniotomy remains common practice. We have introduced a \u201cno ICU, unless\u201d policy for tumor craniotomy patients and evaluate costs, complications, and length of stay.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A prospective cohort study was performed comparing patients that underwent tumor craniotomy for supratentorial tumors during 2 years after introduction of the new policy with the year before.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A reduction in ICU\/MCU admittance from 88 to 23% of patients was found resulting in 13% cost reduction. Also, the new policy resulted in a 1.4-day shorter post-operative length of stay. Minor complications were reduced, while major complications remained the same. All major complications are reviewed.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>We show that routine post-operative ICU\/MCU admittance after tumor craniotomy does not reduce complications, but actually interferes with recovery of our patients. Changing the paradigm results in earlier discharge and cost reduction.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00701-020-04543-y","type":"journal-article","created":{"date-parts":[[2020,9,1]],"date-time":"2020-09-01T11:02:57Z","timestamp":1598958177000},"page":"1879-1882","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Reducing the burden of brain tumor surgery"],"prefix":"10.1007","volume":"163","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9213-430X","authenticated-orcid":false,"given":"Mark","family":"ter Laan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Roelofs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eddy M. M.","family":"Adang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald H. M. A.","family":"Bartels","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,9,1]]},"reference":[{"key":"4543_CR1","doi-asserted-by":"publisher","first-page":"1130","DOI":"10.3171\/2015.11.JNS152151","volume":"125","author":"K Au","year":"2016","unstructured":"Au K, Bharadwaj S, Venkatraghavan L, Bernstein M (2016) Outpatient brain tumor craniotomy under general anesthesia. J Neurosurg 125:1130\u20131135. https:\/\/doi.org\/10.3171\/2015.11.JNS152151","journal-title":"J Neurosurg"},{"key":"4543_CR2","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1016\/S0090-3019(03)00517-2","volume":"60","author":"CL Beauregard","year":"2003","unstructured":"Beauregard CL, Friedman WA (2003) Routine use of postoperative ICU care for elective craniotomy: a cost-benefit analysis. 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Neurocrit Care 28:35\u201342. https:\/\/doi.org\/10.1007\/s12028-017-0433-4","journal-title":"Neurocrit Care"},{"key":"4543_CR5","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1097\/01.sla.0000133083.54934.ae","volume":"240","author":"D Dindo","year":"2004","unstructured":"Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205\u2013213","journal-title":"Ann Surg"},{"key":"4543_CR6","doi-asserted-by":"publisher","first-page":"1392","DOI":"10.3171\/2016.10.JNS16954","volume":"127","author":"JE Florman","year":"2017","unstructured":"Florman JE, Cushing D, Keller LA, Rughani AI (2017) A protocol for postoperative admission of elective craniotomy patients to a non-ICU or step-down setting. J Neurosurg 127:1392\u20131397. https:\/\/doi.org\/10.3171\/2016.10.JNS16954","journal-title":"J Neurosurg"},{"key":"4543_CR7","doi-asserted-by":"publisher","first-page":"E54","DOI":"10.1093\/neuros\/nyz388","volume":"86","author":"MT Laan","year":"2020","unstructured":"Laan MT, Roelofs S, Van Huet I, Adang EMM, Bartels R (2020) Selective intensive care unit admission after adult supratentorial tumor craniotomy: complications, length of stay, and costs. Neurosurgery 86:E54\u2013E59. https:\/\/doi.org\/10.1093\/neuros\/nyz388","journal-title":"Neurosurgery"},{"key":"4543_CR8","doi-asserted-by":"publisher","unstructured":"Mirza FA, Wang C, Pittman T (2017) Can patients safely be admitted to a ward after craniotomy for resection of intra-axial brain tumors? Br J Neurosurg 1\u20135. https:\/\/doi.org\/10.1080\/02688697.2017.1390064","DOI":"10.1080\/02688697.2017.1390064"}],"container-title":["Acta Neurochirurgica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00701-020-04543-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00701-020-04543-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00701-020-04543-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T02:24:15Z","timestamp":1630463055000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00701-020-04543-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,1]]},"references-count":8,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2021,7]]}},"alternative-id":["4543"],"URL":"https:\/\/doi.org\/10.1007\/s00701-020-04543-y","relation":{},"ISSN":["0001-6268","0942-0940"],"issn-type":[{"value":"0001-6268","type":"print"},{"value":"0942-0940","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,1]]},"assertion":[{"value":"29 May 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 August 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 September 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"According to Dutch law, no ethical approval is needed for studies where patients are not subjected to actions and no rules of conduct are imposed on them like in the quality assessment we present.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}