Deep Brain Stimulator Surgery Does Not Require Postoperative Intensive Care Unit Admission.

Abstract

Abstract: BACKGROUND: Historically, patients in an academic tertiary care center were admitted to the intensive care unit (ICU) after Deep brain stimulation (DBS) placement. DBS patients progressed quickly through the ICU and did not require traditional ICU management. We identified an opportunity to shift DBS postoperative care from the ICU to the floor. METHODS: Key stakeholders were engaged to create a protocol to transition postoperative DBS patients from ICU to medical-surgical care. Forty-one DBS patients were admitted postoperatively to the ICU in the 6 months before implementation of the new process, and 22 patients were admitted postoperatively to a medical-surgical level of care in the 6 months of the study. A retrospective chart review of patient outcomes and metrics was completed at the end of the study period. RESULTS: A reduction in ICU use was noted. Only 3 of 22 (14%) patients required ICU care postoperatively because of medical comorbidities in the postimplementation group (P < .0001). CONCLUSION: We were able to manage patients postoperatively on a medical-surgical unit without transfer to a higher level of care. Length of stay was lower without an increase in readmission. Implementation of this pathway resulted in a safe transition of care. Further research could explore financial benefits, a larger sample size, and review of patient demographics.