Risk factors associated with early adverse outcomes following craniotomy for malignant glioma in older adults
| Autor: | Tyler Schmidt, Kwanza T Warren, Samuel B. Tomlinson, Redi Rahmani, Kevin A. Walter, Gabrielle Santangelo, G. Edward Vates |
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| Rok vydání: | 2020 |
| Předmět: |
Pediatrics
medicine.medical_specialty medicine.medical_treatment Logistic regression Patient Readmission 03 medical and health sciences Postoperative Complications 0302 clinical medicine Risk Factors Diabetes mellitus Glioma medicine Humans 030212 general & internal medicine Craniotomy Aged business.industry medicine.disease Regimen Oncology 030220 oncology & carcinogenesis Female Geriatrics and Gerontology Underweight medicine.symptom Complication business Body mass index |
| Zdroj: | Journal of Geriatric Oncology. 11:694-700 |
| ISSN: | 1879-4068 |
| DOI: | 10.1016/j.jgo.2019.10.019 |
| Popis: | Introduction Craniotomy for tumor resection improves survival in adults aged ≥65 years with malignant glioma. However, the decision to attempt resection must be weighed against the near-term risks of surgery. This study examined risk factors associated with unfavorable 30-day outcomes following craniotomy for malignant glioma resection in older adult patients. Materials and Methods The American College of Surgeons National Surgical Quality Improvement Program database from 2012 to 2016 was queried for patients aged 65–89 years undergoing craniotomy for primary, supratentorial, malignant, intra-axial tumor resection. 30-day outcomes included mortality, life-threatening complication, unplanned readmission, reoperation, and change in living disposition. Independent risk factors were identified through multiple logistic regression. Results In total, 1016 cases met eligibility criteria. Death occurred in 35 cases (3.4%). 58 patients (5.7%) suffered at least one life-threatening complication. Risk factors for morbidity and mortality included frontal lobe tumor, corticosteroid use, dependent functional status, and underweight body mass index (BMI). Among 816 patients admitted from home, 33.9% experienced a change in living disposition, which was associated with advanced age, female sex, frontal lobe tumor, underweight BMI, and diabetes mellitus (among others). Readmission (11.8%) was most frequently attributed to altered mental status, seizure, or venous thromboembolism. Reoperation was rare (4.5%). Discussion Death and life-threatening morbidity were rare early outcomes for older adult patients undergoing malignant glioma resection. However, one in three patients admitted from home experienced a change in living disposition. Factors related to baseline state of health, tumor location, and corticosteroid regimen should be considered when anticipating the immediate postoperative course. |
| Databáze: | OpenAIRE |
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