Literature DB >> 27441161

Increased Operative Time for Benign Cranial Nerve Tumor Resection Correlates with Increased Morbidity Postoperatively.

Meghan Murphy1, Hannah Gilder1, Brandon A McCutcheon1, Panagiotis Kerezoudis1, Lorenzo Rinaldo1, Daniel Shepherd1, Patrick Maloney1, Kendall Snyder1, Matthew L Carlson2, Bob S Carter3, Mohamad Bydon1, Jamie J Van Gompel1, Michael J Link1.   

Abstract

OBJECTIVES: Operative time, previously identified as a risk factor for postoperative morbidity, is examined in patients undergoing benign cranial nerve tumor resection. DESIGN/SETTING/PARTICIPANTS: This retrospective cohort analysis included patients enrolled in the ACS-NSQIP registry from 2007 through 2013 with a diagnosis of a benign cranial nerve neoplasm. MAIN OUTCOME MEASURES: Primary outcomes included postoperative morbidity and mortality. Readmission and reoperation served as secondary outcomes.
RESULTS: A total of 565 patients were identified. Mean (median) operative time was 398 (370) minutes. The 30-day complication, readmission, and return to the operating room rates were 9.9%, 9.9%, and 7.3%, respectively, on unadjusted analyses. CSF leak requiring reoperation or readmission occurred at a rate of 3.1%. On multivariable regression analysis, operations greater than 413 minutes were associated with an increased odds of overall complication (OR 4.26, 95% CI 2.08-8.72), return to the operating room (OR 2.65, 95% CI 1.23-5.67), and increased length of stay(1.6 days, 95% CI 0.94-2.23 days). Each additional minute of operative time was associated with an increased odds of overall complication (OR 1.004, 95% CI 1.002-1.006) and increased length of stay (0.006 days, 95% CI 0.004-0.008).
CONCLUSION: Increased operative time in patients undergoing surgical resection of a benign cranial nerve neoplasm was associated with an increased rate of complications.

Entities:  

Keywords:  acoustic neuroma; complications; national surgical quality improvement program; operative time; skull base; vestibular schwannoma

Year:  2016        PMID: 27441161      PMCID: PMC4949053          DOI: 10.1055/s-0036-1572508

Source DB:  PubMed          Journal:  J Neurol Surg B Skull Base        ISSN: 2193-634X


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