Outpatient brain tumor surgery and spinal decompression: a prospective study of 1003 patients.

ABSTRACT

BACKGROUND: Outpatient craniotomy, biopsy, and spinal decompression have been performed at our center for more than a decade. Early feasibility studies suggest that they are safe, successful, cost-effective, and well-tolerated by patients. However, a large-scale study of this magnitude has not been performed. OBJECTIVE: To characterize postoperative complications and the rate of successful discharge from the day surgery unit (DSU). We also discuss patient satisfaction and benefits to flow of care. METHODS: From August 1996 to December 2009, 1003 consecutive patients were prospectively selected as outpatient candidates. Retrospective chart review was performed for all procedures and analyzed by intent to treat. RESULTS: Of 249 patients who underwent a craniotomy, 92.8% were successfully discharged from the DSU, 5.2% were admitted from the DSU, and 2.0% were discharged and later readmitted. Of 602 patients who underwent spinal decompression, 97.3% were successfully discharged from the DSU, 2.5% were admitted from the DSU, and 0.2% were discharged and readmitted at a later date. Of 152 patients who underwent a brain biopsy, 94.1% were successfully discharged from the DSU, 4.6% were admitted from the DSU, and 1.3% were discharged and later readmitted. No patients experienced a negative outcome as a result of early discharge. CONCLUSION: Outpatient craniotomy, biopsy, and spinal decompression are safe, successful, and cost-effective.