OBJECTIVE: Risks of brain surgery in elderly patients with brain metastases are not well defined. This study was designed to quantify the postoperative risk for these patients after brain surgery for metastatic disease to the brain. METHODS: We performed a retrospective analysis of the Nationwide Inpatient Sample (1998-2005). Patients aged 65 years or older who underwent tumor resection of brain metastases were identified by ICD-9 coding. Primary outcome was inpatient death. Other outcomes included systemic postoperative complications, length of stay (LOS), and total charges. RESULTS: A total of 4,907 patients (53.6% men) were identified. Mean age was 72.1 years. Mean Charlson comorbidity score was 7.8. Inpatient mortality was 4%. The most common adverse events were pulmonary complications (3.4%). Mean length of stay was 9.2 days. Mean total charges were $57,596.39. In multivariate analysis, patients up to age 80 years had no significantly greater odds of inpatient death, relative to their 65- to 69-year-old counterparts. Each 1-point increase in Charlson score was associated with 12% increased odds of death, 0.52 days increased LOS, and $1,710.61 higher hospital charges. Postoperative pulmonary complications, stroke, or thromboembolic events increased LOS and total charges by up to 9.6 days and $57,664.42, respectively. These associations were statistically significant (P < 0.05). CONCLUSIONS: Surgical resection of brain metastases among the elderly up to the ninth decade of life is feasible. Age older than 80 years and higher Charlson comorbidity scores were found to be important prognostic factors for inpatient outcome. Incorporating these factors into preoperative decision making may help to select appropriately those elderly candidates for neurosurgical intervention.
OBJECTIVE: Risks of brain surgery in elderly patients with brain metastases are not well defined. This study was designed to quantify the postoperative risk for these patients after brain surgery for metastatic disease to the brain. METHODS: We performed a retrospective analysis of the Nationwide Inpatient Sample (1998-2005). Patients aged 65 years or older who underwent tumor resection of brain metastases were identified by ICD-9 coding. Primary outcome was inpatient death. Other outcomes included systemic postoperative complications, length of stay (LOS), and total charges. RESULTS: A total of 4,907 patients (53.6% men) were identified. Mean age was 72.1 years. Mean Charlson comorbidity score was 7.8. Inpatient mortality was 4%. The most common adverse events were pulmonary complications (3.4%). Mean length of stay was 9.2 days. Mean total charges were $57,596.39. In multivariate analysis, patients up to age 80 years had no significantly greater odds of inpatient death, relative to their 65- to 69-year-old counterparts. Each 1-point increase in Charlson score was associated with 12% increased odds of death, 0.52 days increased LOS, and $1,710.61 higher hospital charges. Postoperative pulmonary complications, stroke, or thromboembolic events increased LOS and total charges by up to 9.6 days and $57,664.42, respectively. These associations were statistically significant (P < 0.05). CONCLUSIONS: Surgical resection of brain metastases among the elderly up to the ninth decade of life is feasible. Age older than 80 years and higher Charlson comorbidity scores were found to be important prognostic factors for inpatient outcome. Incorporating these factors into preoperative decision making may help to select appropriately those elderly candidates for neurosurgical intervention.
Authors: Johannes Lutterbach; Susanne Bartelt; Felix Momm; Gerhild Becker; Hermann Frommhold; Christoph Ostertag Journal: Cancer Date: 2005-03-15 Impact factor: 6.860
Authors: Ahmedin Jemal; Ram C Tiwari; Taylor Murray; Asma Ghafoor; Alicia Samuels; Elizabeth Ward; Eric J Feuer; Michael J Thun Journal: CA Cancer J Clin Date: 2004 Jan-Feb Impact factor: 508.702
Authors: Brett E Youngerman; Alfred I Neugut; Jingyan Yang; Dawn L Hershman; Jason D Wright; Jeffrey N Bruce Journal: J Neurooncol Date: 2017-11-14 Impact factor: 4.130
Authors: Kaisorn L Chaichana; Shami Acharya; Mariana Flores; Olindi Wijesekera; Daniele Rigamonti; Jon D Weingart; Alessandro Olivi; Chetan Bettegowda; Gary L Gallia; Henry Brem; Michael Lim; Alfredo Quinones-Hinojosa Journal: World Neurosurg Date: 2013-09-25 Impact factor: 2.104
Authors: Kaisorn L Chaichana; Shekhar Gadkaree; Karthik Rao; Thomas Link; Daniele Rigamonti; Michael Purtell; Ilene Browner; Jon Weingart; Alessandro Olivi; Gary Gallia; Chetan Bettegowda; Henry Brem; Michael Lim; Alfredo Quinones-Hinojosa Journal: Neurol Res Date: 2013-08-16 Impact factor: 2.448
Authors: Martin N Stienen; David Y Zhang; Morgan Broggi; Dominik Seggewiss; Stefano Villa; Silvia Schiavolin; Oliver Bozinov; Niklaus Krayenbühl; Johannes Sarnthein; Paolo Ferroli; Luca Regli Journal: J Neurooncol Date: 2018-05-02 Impact factor: 4.130
Authors: Kaisorn L Chaichana; Mariana Flores; Shami Acharya; Paul Sampognaro; Chetan Bettegowda; Daniele Rigamonti; Jon D Weingart; Alessandro Olivi; Gary L Gallia; Henry Brem; Michael Lim; Alfredo Quinones-Hinojosa Journal: J Neurol Surg B Skull Base Date: 2013-04-03
Authors: Peter Abraham; Reith Sarkar; Michael G Brandel; Arvin R Wali; Robert C Rennert; Christian Lopez Ramos; Jennifer Padwal; Jeffrey A Steinberg; David R Santiago-Dieppa; Vincent Cheung; J Scott Pannell; James D Murphy; Alexander A Khalessi Journal: Radiology Date: 2019-03-26 Impact factor: 29.146
Authors: Johannes Kerschbaumer; Aleksandrs Krigers; Matthias Demetz; Daniel Pinggera; Julia Klingenschmid; Nadine Pichler; Claudius Thomé; Christian F Freyschlag Journal: J Neurooncol Date: 2022-04-13 Impact factor: 4.506