Predictors of prolonged hospital length of stay following craniotomy for brain tumor resection: A systematic review and meta-analysis.

Abstract

e23245 Background: Hospital length of stay (LOS) is a crucial indicator for assessing the quality of care. Identifying predictors of prolonged hospital LOS helps to improve care quality and reduce healthcare costs. In this study, we conducted a systematic review and meta-analysis to identify the preoperative and operative factors influencing the prolonged hospital LOS in patients undergoing craniotomy for tumor resection. Methods: A comprehensive search was conducted in major databases including PubMed, Google Scholar, ScienceDirect, and Cochrane Library.Covariates included for assessing predictors were age, race or ethnicity, tumor histology, operative time, American Society of Anesthesiologists (ASA) class, and admission source. Heterogeneity was measured as I2 and a p-value of < 0.05 was considered statistically significant. Results: Six observational studies including 18023 patients were analyzed. ASA class 3 (OR, 1.39, CI:1.16-1.63, I2 = 70.51%, p < 0.05), ASA class > 3 (OR, 2.21, CI:1.82-2.60, I2 = 0%, p < 0.05) and admission source other than home (OR, 3.19, CI:2.58-3.79, I2 = 52.31%, p < 0.05) were associated with statistically significant prolonged LOS. Although statistically insignificant, asian ethnicity (OR, 0.98, CI: 0.85-1.12) and tumor resection for meningiomas (OR, 0.68, CI: 0.24-1.13) were associated with lesser LOS while African ethnicity (OR, 1.47, CI:0.97-1.97), longer operative time (OR, 1.19, CI:0.04-2.35) and age > 70 (OR, 1.95, CI:0.65-3.26) were associated with prolonged hospital LOS. Conclusions: Our systematic review and meta-analysis analyzed various preoperative and operative predictors of prolonged hospital LOS in patients undergoing craniotomy for tumor resection. These findings could inform targeted interventions to improve care and reduce costs. Further studies are needed to explore additional determinants and validate these results.