Length of stay in intensive care unit and factors associated with clinical outcomes in patients with postoperative intracranial masses

Aims: This study aimed to evaluate factors associated with intensive care unit (ICU) length of stay (LOS) and mortality in patients who underwent surgical intervention for postoperative intracranial masses and required ICU monitoring. Methods: This retrospective, single-center observational study included adult patients who underwent intracranial mass surgery and were followed in the ICU for at least 48 hours between January 2017 and December 2025. Demographic characteristics, comorbidities, tumor-related variables, clinical scores (Glasgow Coma Scale and APACHE II), need for and duration of mechanical ventilation, ICU complications, LOS, and mortality were recorded. Prolonged ICU stay was defined as >3 days. Univariate and multivariate logistic regression analyses were performed to identify independent predictors of prolonged ICU stay. Results: A total of 128 patients were included. The median ICU LOS was 3 days, and ICU mortality was 25.8%. Mechanical ventilation requirement, ventilation duration, respiratory complications, and higher APACHE II scores were significantly associated with both ICU LOS and mortality. In multivariate analysis, the APACHE II score was the only independent predictor of prolonged ICU stay (OR: 0.924, 95% CI: 0.862–0.991; p = 0.027). Tumor type showed an association with ICU LOS in univariate analyses, whereas tumor location was not independently associated with outcomes. Conclusion: In patients with postoperative intracranial masses, ICU LOS and mortality are primarily influenced by acute clinical severity and systemic complications rather than tumor characteristics. The APACHE II score is an independent predictor of prolonged ICU stay, highlighting the importance of early risk stratification to optimize ICU resource utilization.