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Clin Neurol Neurosurg. 2016 Jan;140:6-10. doi: 10.1016/j.clineuro.2015.11.005. Epub 2015 Nov 12.

Surgical complications following malignant brain tumor surgery: An analysis of 2002-2011 data.

Author information

1
Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
2
Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA.
3
Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA. Electronic address: bydon.mohamad@mayo.edu.

Abstract

OBJECTIVES:

To estimate the incidence of surgical complications and associated in-hospital morbidity and mortality following surgery for malignant brain tumors.

PATIENTS AND METHODS:

The Nationwide Inpatient Sample (NIS) database was queried from 2002 to 2011. All adult patients who underwent elective brain surgery for a malignant brain tumor were included. Surgical complications included wrong side surgery, retention of a foreign object, iatrogenic stroke, meningitis, hemorrhage/hematoma complicating a procedure, and neurological complications. A regression model was conducted to estimate the odds ratios (OR) with their 95% confidence intervals (95% CI) of in-hospital mortality for each surgical complication.

RESULTS:

A total of 16,530 admissions were analyzed, with 601 (36.2 events per 1000 cases) surgical complications occurring in 567 patients. Over the examined 10-year period, the overall incidence of surgical complications did not change (P=0.061) except for iatrogenic strokes, which increased in incidence from 14.1 to 19.8 events per 1000 between 2002 and 2011 (P=0.023). Patients who developed a surgical complication had significantly longer lengths of stay, total hospital costs, and higher rates of other complications. Patients who experienced an iatrogenic stroke had a significantly increased risk of mortality (OR 9.6; 95% 6.3-14.8) and so were patients with a hemorrhage/hematoma (OR 3.3; 95% CI 1.6-6.6).

CONCLUSION:

In this study of an administrative database, patients undergoing surgery for a malignant brain tumor who suffered from a surgical complication had significantly longer lengths of stay, total hospital charges, and complication rates. Having a surgical complication was also an independent risk factor for in-hospital mortality. Nonetheless, it is unclear whether all surgical complications were clinically relevant, and further research is encouraged.

KEYWORDS:

Malignant brain tumor; Nationwide inpatient sample; Neurosurgery; Sentinel event; Surgical complication

PMID:
26615463
PMCID:
PMC4750489
DOI:
10.1016/j.clineuro.2015.11.005
[Indexed for MEDLINE]
Free PMC Article

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