Predictors of 30-day postoperative systemic complications in geriatric patients undergoing elective brain tumor surgery. (March 2021)

• Record Type: Journal Article
• Authors: Zhang, John J.Y.; Ong, Jamie A.H.; Tan, Yu Xiang; Yeo, Joshua Y.P.; Lee, Keng Siang; Goh, Chun Peng; Bolem, Nagarjun; Tan, Chin Lik; Yuan, Si Yang; Teo, Kejia; Lwin, Sein; Yeo, Tseng Tsai; Kirollos, Ramez W.; Nga, Vincent D.W.
• Is Part Of: Journal of clinical neuroscience. Volume 85(2021)
• Page Start: 72
• Page End: 77
• Publication Date: 2021-03
• Subjects: Geriatric -- Elderly -- Neurosurgery -- Brain tumor -- Complication -- Outcome -- Morbidity; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2020.12.023
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: Thirty-day systemic complication rate was 24.5% after geriatric brain tumor surgery. Thirty-day mortality rate was low at 0.5% (one out of 212 patients). Risk factors included KPS score, female sex and chronic liver disease among others. ASA status was not found to be a useful predictor of 30-day systemic complications. Brain tumor surgery can be safe in carefully-selected geriatric patients. Abstract: Little evidence exists to guide the preoperative selection of elderly brain tumor patients who are fit for surgery. We aimed to evaluate the safety of brain tumor resection in geriatric patients and identify predictors of postoperative 30-day systemic complications. We conducted a retrospective cohort study of 212 consecutive patients at or above the age of 60 years who underwent elective brain tumor resection between 2007 and 2017. The primary outcome measures analyzed were perioperative systemic complications within 30 days after the operation. A total of 212 geriatric brain tumor patients were included. Fifty-two (24.5%) had a 30-day systemic complication. Among them, 29 (13.7%) had systemic infections, 13 (6.1%) had perioperative seizures, 10 (4.7%) had syndrome of inappropriate antidiuretic hormone secretion (SIADH), five (2.4%) had deep venous thrombosis (DVT), four (1.9%) had perioperative stroke, three (1.4%) had acute myocardial infarction (AMI) and three (1.4%) had central nervous system (CNS) infections. One patient (0.5%) died. Perioperative stroke was predicted by previous stroke (p = 0.040), chronic liver disease (p < 0.001) and vestibular schwannoma (p = 0.002 with reference to meningiomas). Perioperative AMI was predicted by co-existing ischemic heart disease (p = 0.031). Systemic infection was predicted by female gender (p = 0.007) and preoperative Karnofsky Performance Scale (KPS) score < 70 (p = 0.019). DVT was predicted by GBM (p = 0.014). In conclusion, brain tumor surgery can be safe in carefully-selected geriatric patients. The risk factors identified in this study would be helpful to select suitable candidates for surgery.