490 Predictors of Prolonged Length of Stay in Laser Interstitial Thermal Therapy for Intracranial Pathologies: A Single Center Experience

INTRODUCTION: Laser interstitial thermal therapy (LITT) offers a minimally invasive approach for treating intracranial pathologies, often with shorter hospital stays than traditional craniotomies. Yet, some patients still face prolonged length of stay (PLOS), highlighting the need to identify contributing factors and improve post-LITT outcomes. METHODS: A retrospective review was conducted between 2013–2023 for patients undergoing LITT for intracranial pathology at a tertiary care center. PLOS was defined as discharge >2 days. Multivariate logistic regression analyzed variables as contributors to PLOS including preoperative maximum tumor diameter (cm), lesion location, lesion pathology (high grade glioma (HGG)/glioblastoma (GBM) vs. other), and mFI-11 score (binary = or < 75th percentile). RESULTS: The cohort consisted of 288 patients, with 29% (83/288) and 71% (205/288) having PLOS and non-PLOS, respectively. Mean age was similar between the PLOS (63-years) and non-PLOS (60-years) groups (p = 0.09). The PLOS group had a 55% male predominance compared to 57% female in the non-PLOS group. Greater mFI-11 scores showed increased risk of PLOS (4.01, [2.11, 7.60], p < 0.000). Lesions having a subcortical location (3.43 [1.70, 6.95], p = 0.001) or diagnosis of HGG or GBM (2.87 [1.54, 5.34], p = 0.001) had increased risk of PLOS. Importantly, maximum pre-operative diameter did not significantly alter risk of PLOS (1.05 [0.98, 1.13], p = 0.151). CONCLUSIONS: For the first time, we show that patient comorbidities, subcortical lesion location, and HGG/GBM pathology portend increased risk of PLOS following LITT. Future work should validate our model with the goal of optimizing post-operative patient management and resource allocation.