Perioperative Complication Profile of Skull Base Meningioma Resection in Older versus Younger Adult Patients.

Autor: Przybylowski CJ; Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, United States., Shaftel KA; Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, United States., Hendricks BK; Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, United States., Chapple KM; Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, United States., Stevens SM; Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, United States., Porter RW; Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, United States., Sanai N; Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, United States., Little AS; Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, United States., Almefty KK; Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, United States.
Jazyk: angličtina
Zdroj: Journal of neurological surgery. Part B, Skull base [J Neurol Surg B Skull Base] 2021 Oct 12; Vol. 83 (4), pp. 411-417. Date of Electronic Publication: 2021 Oct 12 (Print Publication: 2022).
DOI: 10.1055/s-0041-1736408
Abstrakt: Objectives  To better understand the risk-benefit profile of skull base meningioma resection in older patients, we compared perioperative complications among older and younger patients. Design  Present study is based on retrospective outcomes comparison. Setting  The study was conducted at a single neurosurgery institute at a quaternary center. Participants  All older (age ≥ 65 years) and younger (<65 years) adult patients treated with World Health Organization grade 1 skull base meningiomas (2008-2017). Main Outcome Measures  Perioperative complications and patient functional status are the primary outcomes of this study. Results  The analysis included 287 patients, 102 older and 185 younger, with a mean (standard deviation [SD]) age of 72 (5) years and 51 (9) years ( p  < 0.01). Older patients were more likely to have hypertension ( p  < 0.01) and type 2 diabetes mellitus ( p  = 0.01) but other patient and tumor factors did not differ ( p ≥ 0.14). Postoperative medical complications were not significantly different in older versus younger patients (10.8 [11/102] vs. 4.3% [8/185]; p  = 0.06) nor were postoperative surgical complications (13.7 [14/102] vs. 10.8% [20/185]; p  = 0.46). Following anterior skull base meningioma resection, diabetes insipidus (DI) was more common in older versus younger patients (14 [5/37] vs. 2% [1/64]; p  = 0.01). Among older patients, a decreasing preoperative Karnofsky performance status score independently predicted perioperative complications by logistic regression analysis ( p  = 0.02). Permanent neurologic deficits were not significantly different in older versus younger patients (12.7 [13/102] vs. 10.3% [19/185]; p  = 0.52). Conclusion  The overall perioperative complication profile of older and younger patients was similar after skull base meningioma resection. Older patients were more likely to experience DI after anterior skull base meningioma resection. Decreasing functional status in older patients predicted perioperative complications.
Competing Interests: Conflict of Interest None declared.
(Thieme. All rights reserved.)
Databáze: MEDLINE
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