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Necessity of mandatory postoperative intensive care unit management after clipping surgery for unruptured intracranial aneurysms.

Authors :
Lee JM
Lee S
Park W
Park JC
Ahn JS
Kim JH
Byun J
Source :
Clinical neurology and neurosurgery [Clin Neurol Neurosurg] 2023 May; Vol. 228, pp. 107703. Date of Electronic Publication: 2023 Mar 31.
Publication Year :
2023

Abstract

Objective: Many neurosurgeons routinely perform postoperative intensive care unit (ICU) management after clipping of unruptured intracranial aneurysms (UIAs). However, whether routine postoperative ICU care is necessary remains a clinical question. Therefore, we investigated which factors acted as risk factors that actually required ICU care after microsurgical clipping of unruptured aneurysms.<br />Methods: We included a total of 532 patients who underwent clipping surgery for UIA between January 2020 and December 2020. The patients were divided into two groups: those who really required ICU care (41 patients, 7.7%) and those who did not (491 patients, 92.3%). A backward stepwise logistic regression model was used to identify factors that were independently associated with ICU care requirement.<br />Results: The mean hospital stay duration and the operation time were significantly longer in the ICU requirement group than in the no ICU requirement group (9.9 ± 10.7 vs. 6.3 ± 3.7 days, p = 0.041), (259.9 ± 128.4 vs. 210.5 ± 46.1 min, p = 0.019). The transfusion rate was significantly higher (p = 0.024) in the ICU requirement group. Multivariable logistic regression analysis identified male sex (odds ratio [OR], 2.34; 95% confidence interval [CI], 1.15-4.76; p = 0.0195), operation time (OR, 1.01; 95% CI, 1.00-1.01; p = 0.0022), and transfusion (OR, 2.35; 95% CI, 1.00-5.51; p = 0.0500) as independent risk factors for requiring ICU care after clipping.<br />Conclusions: Postoperative ICU management may not be mandatory after clipping surgery for UIAs. Our results suggest that postoperative ICU management may be more required in the male sex, patients with longer operation times, and those who received a transfusion.<br />Competing Interests: Declarations The authors declare no competing interests regarding this study.<br /> (Copyright © 2023 Elsevier B.V. All rights reserved.)

Details

Language :
English
ISSN :
1872-6968
Volume :
228
Database :
MEDLINE
Journal :
Clinical neurology and neurosurgery
Publication Type :
Academic Journal
Accession number :
37058770
Full Text :
https://doi.org/10.1016/j.clineuro.2023.107703