Jiri Bartek1, Kristin Sjåvik2, Petter Förander3, Ole Solheim4, Sasha Gulati5, Clemens Weber6, Tor Ingebrigtsen2, Asgeir S Jakola7. 1. Department of Clinical Neuroscience, Section for Neurosurgery, Karolinska Institutet, Stockholm, Sweden; Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Department of Neurosurgery, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark. Electronic address: jiri.bartek@karolinska.se. 2. Department of Neurosurgery, University Hospital of North Norway, Tromsø, Norway. 3. Department of Clinical Neuroscience, Section for Neurosurgery, Karolinska Institutet, Stockholm, Sweden; Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden. 4. Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway; Norwegian Advisory Unit for Ultrasound and Image-Guided Surgery, Trondheim, Norway. 5. Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway; Norwegian Centre of Competence in Deep Brain Stimulation for Movement Disorders, St. Olavs University Hospital, Trondheim, Norway. 6. Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway; National Advisory Unit on Spinal Surgery, St. Olavs University Hospital, Trondheim, Norway; Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway. 7. Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway; Norwegian Advisory Unit for Ultrasound and Image-Guided Surgery, Trondheim, Norway; Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
Abstract
OBJECTIVE: To investigate predictors of complications after intracranial meningioma resection using a standardized reporting system for adverse events. METHODS: A retrospective review was conducted in a Scandinavian population-based cohort of 979 adult operations for intracranial meningioma performed at 3 neurosurgical centers with population-based referral between January 1, 2007, and June 30, 2013. Possible predictors of severe complications were identified and analyzed in univariable analyses. Variables with a P value < 0.10 were included in a multivariable model. RESULTS: Severe complications were observed in 68 (7%) operations. Univariable analyses identified patient age >70 years (P < 0.001), male sex (P = 0.03), Charlson Comorbidity Index >1 (P = 0.02), Simpson grade >3 (P = 0.03), Karnofsky performance scale score <70 (P < 0.001), and duration of surgery >4 hours (P < 0.001) as significant predictors of severe complications. Age >70 (odds ratio = 2.5, P < 0.01), duration of surgery >4 hours (odds ratio = 3.2, P < 0.001), and Karnofsky performance scale score <70 (odds ratio = 2.5, P < 0.01) were independent predictors of severe complications in the multivariable regression analysis. CONCLUSIONS: Severe complications after meningioma resection are more encountered often in elderly patients (>70 years old), dependent patients (Karnofsky performance scale score <70), and patients who underwent longer lasting surgery (>4 hours). Patient selection, including careful consideration of the individual risk-benefit ratio, is important in improving the safety of intracranial meningioma resection.
OBJECTIVE: To investigate predictors of complications after intracranial meningioma resection using a standardized reporting system for adverse events. METHODS: A retrospective review was conducted in a Scandinavian population-based cohort of 979 adult operations for intracranial meningioma performed at 3 neurosurgical centers with population-based referral between January 1, 2007, and June 30, 2013. Possible predictors of severe complications were identified and analyzed in univariable analyses. Variables with a P value < 0.10 were included in a multivariable model. RESULTS: Severe complications were observed in 68 (7%) operations. Univariable analyses identified patient age >70 years (P < 0.001), male sex (P = 0.03), Charlson Comorbidity Index >1 (P = 0.02), Simpson grade >3 (P = 0.03), Karnofsky performance scale score <70 (P < 0.001), and duration of surgery >4 hours (P < 0.001) as significant predictors of severe complications. Age >70 (odds ratio = 2.5, P < 0.01), duration of surgery >4 hours (odds ratio = 3.2, P < 0.001), and Karnofsky performance scale score <70 (odds ratio = 2.5, P < 0.01) were independent predictors of severe complications in the multivariable regression analysis. CONCLUSIONS: Severe complications after meningioma resection are more encountered often in elderly patients (>70 years old), dependent patients (Karnofsky performance scale score <70), and patients who underwent longer lasting surgery (>4 hours). Patient selection, including careful consideration of the individual risk-benefit ratio, is important in improving the safety of intracranial meningioma resection.
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