Medical Student Emory University School of Medicine
Introduction: Protocols for postoperative length of stay following stereotactic brain biopsy vary significantly across centers. We hypothesized that most complications occur early, indicating that same-day discharge may provide sufficient monitoring, reduce costs, and optimize resource use.
Methods: We performed a retrospective chart review on adult patients who underwent brain biopsy at a multicenter institution between March 2019 and January 2024. Non-contrast computed tomography was obtained within 6 hours post-surgery, with hemorrhage identified via radiology reports and confirmed by independent review. Symptomatic complications were defined as any transient or permanent neurological deficits, regardless of treatment requirements. Data were reported as median [IQR] for continuous variables and as proportions for categorical variables.
Results: The cohort included 150 patients (median age 64 [54-73] years; 43% female, 65% White, 5% Hispanic). Patients had a median Karnofsky Performance Status (KPS) of 80 [70-90] and a median lesion size of 35 [23-47] mm, with most lesions located cortically (75%) and most diagnoses being malignant (59%). No significant demographic or clinical differences were observed between patients with and without postoperative complications. The hemorrhage rate was 9% and the symptomatic complication rate was 7%. Among all complications, 41% occurred within the first hour, 73% within 6 hours, and the median time to complication onset was 2 [1-6] hours. The biopsy-related 30-day readmission rate was 9% among patients with any complication.
Conclusion : Stereotactic brain biopsy is associated with a low rate of complications, most of which occur within the first 6 hours postoperatively. These findings suggest that monitoring within this early period may be sufficient for safe discharge planning, potentially enabling same-day discharge for most patients.
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