Neuroanesthesia & neurocritical care
Awake Craniotomy Program Implementation
Authors' conclusion
In this economic evaluation of standardization of awake craniotomy, there was a generalized reduction in length of stay, ICU admission time, and direct medical costs with implementation of an optimized protocol.
Study context
- Population
- Patients with single, unilateral lesions undergoing elective awake craniotomy, Mayo Clinic Florida, January 2016–December 2021
- Participants
- 164 patients
- Exposure
- Awake craniotomy after vs before program standardization
- Prestandardizationn = 56reference
- Standardizationn = 108
- Outcome
- Cost utility (direct medical costs and 1-year mortality); institutional perspective
- Follow-up
- 1 year
Methodological detailscost-utility analysis, single-centre, before-after comparison, probability sensitivity analysis
- Cost-utility analysis
- Single-centre
- Before-after comparison
- Probability sensitivity analysis
Main finding
As reported in the abstract
Cost utility (direct medical costs and 1-year mortality)
The standardized protocol was associated with mean (SD) savings
$7088.80
$12 389.50
Cost saving in probability sensitivity analysis simulations
75.5%
Observational data: associations, not effects.
Further findings
Mean, days
| Outcome | Prestandardization | Standardization | Difference (days) (95% CI) | P value | |
|---|---|---|---|---|---|
| LOSReduction | 3.34 (SD 1.79) | 2.46 (SD 1.61) | 0.88 (0.33–1.42) | P = 0.002 | |
| −1012Difference, days (linear scale) |
| Outcome | Prestandardization | Standardization | Difference (nights) (95% CI) | P value | |
|---|---|---|---|---|---|
| ICU LOSReduction | mean 1.32 (SD 0.69) nights | mean 0.99 (SD 0.90) nights | 0.33 (0.06–0.60) | P = 0.02 | |
| −0.500.51Difference, nights (linear scale) |
30-day readmission
difference 9% (19.6%–0.3%) · P = 0.03
Extent of resection
- Similar between both cohorts
Safety
Intraoperative complications
- Similar between both cohorts
Original publication
Awake Craniotomy Program Implementation. JAMA Netw Open. Published 2 January 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →