Background Glial tumours are the most common central nervous system (CNS) neoplastic lesions. They occur in 7 per 100,000 individuals in the United Kingdom (UK) and are categorized into astrocytomas, oligodendrogliomas, and glioblastomas in the adult population. The World Health Organization (WHO) has created a classification system in order to better categorise these lesions, placing them in a range from grade I to grade IV. The higher the grade, the poorer the prognosis. The National Institute of Health and Care Excellence (NICE) in the United Kingdom recommends that all surgical resections of glial brain tumours are followed by a postoperative magnetic resonance imaging (MRI) scan within a 72-hour to establish a baseline for further management. Objective We present a retrospective analysis that assessed the compliance rate with NICE guidelines among patients who underwent surgical resection of glial lesions at the Department of Neurosurgery, Queens Hospital Romford, between January 2022 and September 2023. Materials and methods A retrospective analysis was conducted on 136 glial tumour resections that were performed during the period between January 2022 and September 2023. The total time between the end of the operation and the MRI scan was calculated in hours for each procedure. This was analyzed into two groups with respect to compliance with the NICE guidelines, which are within 72 hours and after 72 hours. The non-compliant group was then further investigated regarding the reason for the delay. The cost related to delays was also determined by discussion with the hospital's finance department. Results All of the procedures were followed by a post-operative MRI scan but only 88% were within the timeframe recommended by NICE guidelines. The amount of delay was calculated in hours and the reasons for these delays were identified. We created two categories for delay: requesting delays and radiology department-related delays with an almost equivalent number of delays resulting from each category. This delay has resulted in approximately £19,845 of extra costs for inpatient stays. Conclusion A retrospective analysis at Queens Hospital, Romford, found good compliance with NICE guidelines for post-operative MRI scans in glial lesion resections from January 2022 to September 2023. Eighty-eight per cent of patients received scans within 72 hours, crucial for baseline assessment. A 12% non-compliance rate revealed areas for improvement, causing £19,845 in extra costs due to longer inpatient stays. Expediting scans to 36 hours could save around £30,876 annually and reduce complications like infections and thromboembolism. Proposed strategies include dedicated MRI slots and policy adjustments for MRI requests.
Keywords: brain tumors; glioma; mri imaging; neurosurgery; nice guidelines; quality improvement project; single-center; surgical resection.
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