How the elderly fare after brain tumor surgery compared to younger patients within a 30-day follow-up: A National surgical Quality Improvement Program analysis of 30,183 cases
| Autor: | Daniel W. Branch, Joel T. Patterson, Anna M. Nia, Rishi R. Lall, June Yowtak-Guillet, Thomas Frank, Kenneth I. Maynard |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Reoperation Pediatrics medicine.medical_specialty medicine.medical_treatment Operative Time Logistic regression 03 medical and health sciences 0302 clinical medicine Postoperative Complications Risk Factors Physiology (medical) Medicine Humans Risk factor Adverse effect Craniotomy Aged Retrospective Studies Aged 80 and over business.industry Brain Neoplasms Confounding Age Factors General Medicine Perioperative Length of Stay Middle Aged medicine.disease Quality Improvement United States Neurology 030220 oncology & carcinogenesis Case-Control Studies Surgery Female Neurology (clinical) Metabolic syndrome business Complication 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia. 78 |
| ISSN: | 1532-2653 |
| Popis: | The growing elderly population in Western societies has led to an increasing number of primary brain tumors occurring in patients beyond the age of 65. The purpose of this study was to assess and compare the safety, efficacy, and outcomes of oncological craniotomy procedures between patients above and below 65 years. We performed a retrospective analysis of the ACS-NSQIP database to identify patients undergoing supratentorial and infratentorial tumor excisions by neurosurgeons between 2008 and 2016. We stratified them based on a cutoff age of 65 years and analyzed for minor and major complications, reoperation, the total length of hospital stay, and mortality within a standardized 30-day follow-up. Among the 30,183 analyzed patients, 9,652 (32%) were elderly (age ≥ 65). The bivariate analysis demonstrated significantly increased risk of complications, including major and minor complications and mortality in patients with metabolic syndrome, preoperative steroid use, and ASA classification ≥3. (p-value ≤ 0.001***). After controlling for confounding variables in our logistic regression models, older age, metabolic syndrome, extended operative time beyond 5 h, dependent functional health status, ASA class ≥3, steroid use pre-operatively, and black/African American race were found to be significant predictors of major and minor complication. Our study provides a comprehensive analysis of perioperative risk factors and predictors of adverse outcomes following craniotomy for supratentorial and infratentorial tumors in elderly patients. We identified increased age as an independent risk factor for minor and major adverse events as well as extended hospitalization. |
| Databáze: | OpenAIRE |
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