Length of stay following elective craniotomy for tumor resection in children and young adults: a retrospective case series.

Purpose: Length of stay (LOS) is a critical metric of healthcare delivery. Prolonged LOS is associated with a heightened risk of adverse complications. We aimed to provide a comprehensive evaluation of LOS, specifically identifying variables associated with extended LOS (eLOS), in children and young adults following elective craniotomy for tumor resection.

Methods: All elective craniotomies for tumor resection performed at our tertiary care children's hospital from January 2010 to December 2022 were included for review, excluding patients > 21 years of age. Demographic, clinical, and procedural variables for each craniotomy were collected. LOS was defined as the interval in days from index surgery to discharge. eLOS was defined as greater than 7 days.

Results: 1,276 patients underwent a total of 1,497 elective craniotomies for tumor resection. The median age was 9.45 years old, with the most common age group being > 10 years (45.6%). Most patients had supratentorial tumors (63.4%) and underwent de novo surgery (60.7%). Patients with an eLOS experienced longer ICU admissions, longer surgical times, and were younger. Variables found to be significantly associated with eLOS were posterior fossa resection (OR = 2.45), de novo craniotomy (OR = 0.49), prior shunt or ETV (OR = 1.80), tumor type (craniopharyngioma (OR = 3.74) and medulloblastoma (OR = 0.51)), and the presence of at least one postoperative event (POE) (OR = 29.85).

Conclusion: This is the largest study evaluating factors (patient, tumor, surgical) associated with eLOS after elective craniotomy for tumor resection in children and young adults. The findings of this clinical study are important for preoperative counseling, neurosurgical team preparedness, and healthcare delivery optimization.