Surgical Treatment, Length of Stay, and In-Hospital Mortality Among Patients With Intracranial Tumors at a Tertiary Centre in Angola: A Retrospective Cohort Study
In a retrospective cohort study of 93 intracranial tumor admissions at an Angolan tertiary center, surgical treatment was found to significantly prolong hospital length of stay but was not associated with increased in-hospital mortality.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
Inside the human skull, a complex landscape of tissue and fluid supports our thoughts, movements, and senses. When abnormal growths, known as intracranial tumors, appear in this space, they can disrupt that delicate balance, causing pressure, seizures, or weakness. Treating these conditions often requires a team of specialists to decide on the best path forward. Sometimes the solution involves a surgical operation to remove or reduce the growth, while other times, the risks of cutting into the brain are too high, and doctors must rely on other forms of care. For hospitals, managing these patients is a heavy task. It consumes beds, staff time, and resources, and the length of a patient's stay often depends on how complex their journey through the hospital is. Understanding whether surgery makes a hospital stay longer, and whether it changes the chance of a patient surviving their time in the hospital, helps administrators and doctors plan better for the future.
Researchers at Hospital do Prenda in Luanda, Angola, set out to examine these questions using records from their own institution. They looked back at 93 separate hospital admissions for patients with brain tumors between the years 2020 and 2025. The team treated each hospital visit as a single event to analyze, grouping them into two categories: those where a surgical operation was performed and those where it was not. Their goal was to see if the decision to operate was linked to how long patients stayed in the hospital or if it changed the likelihood of a patient passing away before leaving the facility.
The data revealed a clear difference in how long patients stayed based on whether they had surgery. Across all 93 visits, the average time spent in the hospital was nearly 30 days, but the middle value, which represents the typical experience, was 23 days. When the researchers separated the groups, the pattern became distinct. Patients who underwent surgery stayed significantly longer. Their median length of stay was 35.5 days, compared to just 14.5 days for those who did not have an operation. This difference was so pronounced that it was statistically unlikely to be a random occurrence. The researchers noted that this longer stay does not necessarily mean the care was worse or that the patients were sicker; rather, it reflects the extra steps required for a surgical journey. A surgical admission involves preoperative preparation, the operation itself, postoperative monitoring, wound checks, and coordination for discharge, all of which add time to the total stay.
Despite the longer time in the hospital, the study found no evidence that surgery increased the risk of death while the patient was still in the building. Among the 93 admissions, 21 ended in death, but the researchers could not find a link between having an operation and this outcome. The data suggested that whether a patient had surgery or not did not predict who would pass away during their hospital stay. Similarly, the length of time a patient stayed in the hospital did not distinguish between those who died and those who were discharged. Some patients who died had short stays, while others stayed for weeks, and the same was true for those who survived. This indicates that the duration of the hospital visit is not a simple signal of a fatal outcome.
The study also highlighted the heavy burden surgical cases place on hospital resources. Although surgical patients made up less than half of all admissions, their much longer stays meant they occupied a disproportionate amount of bed space. The researchers concluded that in this specific hospital setting, the label of "surgery" serves better as a marker for a more intensive and resource-heavy care path than as a predictor of short-term survival. Because the data came from routine records and lacked detailed information on the specific types of tumors or the overall health of the patients before they arrived, the researchers could not prove that surgery caused the longer stays or that it had no effect on survival. Instead, they offered a clear description of how these patients moved through the system. The findings suggest that for hospital planners, the focus should be on streamlining the complex steps surrounding surgery to manage bed occupancy, rather than viewing the longer stay as a sign of poor care or a direct cause of death.
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