HCP-21: RISK FACTORS ASSOCIATED WITH AN EXTENDED LENGTH OF STAY FOLLOWING CRANIOTOMY FOR PRIMARY BRAIN TUMORS

BACKGROUND: The healthcare reform implementation will bring about a paradigm shift that links reimbursement to quality care. Length of stay is an important quality metric measure for determining the distribution of medical resources and their consumption. Understanding which factors lead to a longer length of stay can provide information essential for reducing medical costs and improving the quality of medical care patients receive. METHODS: The authors performed a retrospective chart review of all patients who underwent craniotomies for resection of primary brain tumors at the Moffitt Cancer Center from 2004-2014. Patient demographics (age, gender), clinical characteristics (comorbidities, steroid dose, seizure status, neurologic deficit, KPS), tumor characteristics (tumor type, location), surgical factors (primary or redo, length of surgery, blood loss), 30 day complications (infection, DVT/PE, seizure), and length of stay were assessed. Multivariate analysis was performed to determine risk factors associated with prolonged length of stay. RESULTS: 864 consecutive patients underwent craniotomies for primary braneurologic deficits) tumors, WHO grade 1-4. Low Karnofsky Performance Status (KPS) score, high-dose steroid administration, and peri-operative seizures are associated with prolonged hospital stay. Additionally, those with KPS > 80 had a higher likelihood of being discharged on postoperative day 1. CONCLUSIONS: This study provides estimates of the risks of prolonged hospital length of stay based on patient demographic, comorbidities, and surgical factors, which could potentially be used as an adjunct for risk stratification for patients undergoing brain surgery.