BACKGROUND: Despite improved perioperative management, the rate of postoperative morbidity and mortality after brain tumor resection remains considerably high. OBJECTIVE: To assess the rates, causes, timing, and predictors of major complication, extended length of stay (>10 d), reoperation, readmission, and death within 30 d after craniotomy for primary malignant brain tumors. METHODS: Patients were extracted from the National Surgical Quality Improvement Program registry (2005-2015) and analyzed using multivariable logistic regression. RESULTS: A total of 7376 patients were identified, of which 948 (12.9%) experienced a major complication. The most common major complications were reoperation (5.1%), venous thromboembolism (3.5%), and death (2.6%). Furthermore, 15.6% stayed longer than 10 d, and 11.5% were readmitted within 30 d after surgery. The most common reasons for reoperation and readmission were intracranial hemorrhage (18.5%) and wound-related complications (11.9%), respectively. Multivariable analysis identified older age, higher body mass index, higher American Society of Anesthesiologists (ASA) classification, dependent functional status, elevated preoperative white blood cell count (white blood cell count [WBC], >12 000 cells/mm3), and longer operative time as predictors of major complication (all P < .001). Higher ASA classification, dependent functional status, elevated WBC, and ventilator dependence were predictors of extended length of stay (all P < .001). Higher ASA classification and elevated WBC were predictors of reoperation (both P < .001). Higher ASA classification and dependent functional status were predictors of readmission (both P < .001). Older age, higher ASA classification, and dependent functional status were predictors of death (all P < .001). CONCLUSION: This study provides a descriptive analysis and identifies predictors for short-term complications, including death, after craniotomy for primary malignant brain tumors.
BACKGROUND: Despite improved perioperative management, the rate of postoperative morbidity and mortality after brain tumor resection remains considerably high. OBJECTIVE: To assess the rates, causes, timing, and predictors of major complication, extended length of stay (>10 d), reoperation, readmission, and death within 30 d after craniotomy for primary malignant brain tumors. METHODS:Patients were extracted from the National Surgical Quality Improvement Program registry (2005-2015) and analyzed using multivariable logistic regression. RESULTS: A total of 7376 patients were identified, of which 948 (12.9%) experienced a major complication. The most common major complications were reoperation (5.1%), venous thromboembolism (3.5%), and death (2.6%). Furthermore, 15.6% stayed longer than 10 d, and 11.5% were readmitted within 30 d after surgery. The most common reasons for reoperation and readmission were intracranial hemorrhage (18.5%) and wound-related complications (11.9%), respectively. Multivariable analysis identified older age, higher body mass index, higher American Society of Anesthesiologists (ASA) classification, dependent functional status, elevated preoperative white blood cell count (white blood cell count [WBC], >12 000 cells/mm3), and longer operative time as predictors of major complication (all P < .001). Higher ASA classification, dependent functional status, elevated WBC, and ventilator dependence were predictors of extended length of stay (all P < .001). Higher ASA classification and elevated WBC were predictors of reoperation (both P < .001). Higher ASA classification and dependent functional status were predictors of readmission (both P < .001). Older age, higher ASA classification, and dependent functional status were predictors of death (all P < .001). CONCLUSION: This study provides a descriptive analysis and identifies predictors for short-term complications, including death, after craniotomy for primary malignant brain tumors.
Authors: Yang Yang; Anna M Zeitlberger; Marian C Neidert; Victor E Staartjes; Morgan Broggi; Costanza Maria Zattra; Flavio Vasella; Julia Velz; Jiri Bartek; Alexander Fletcher-Sandersjöö; Petter Förander; Darius Kalasauskas; Mirjam Renovanz; Florian Ringel; Konstantin R Brawanski; Johannes Kerschbaumer; Christian F Freyschlag; Asgeir S Jakola; Kristin Sjåvik; Ole Solheim; Bawarjan Schatlo; Alexandra Sachkova; Hans Christoph Bock; Abdelhalim Hussein; Veit Rohde; Marike L D Broekman; Claudine O Nogarede; Cynthia M C Lemmens; Julius M Kernbach; Georg Neuloh; Niklaus Krayenbühl; Paolo Ferroli; Luca Regli; Oliver Bozinov; Martin N Stienen Journal: Brain Spine Date: 2021-10-21
Authors: Regin Jay Mallari; Michael B Avery; Alex Corlin; Amalia Eisenberg; Terese C Hammond; Neil A Martin; Garni Barkhoudarian; Daniel F Kelly Journal: PLoS One Date: 2021-07-29 Impact factor: 3.240