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World Neurosurg. 2019 May 10. pii: S1878-8750(19)31284-7. doi: 10.1016/j.wneu.2019.05.010. [Epub ahead of print]

Early postoperative complications in meningioma: predictive factors and impact on outcome.

Author information

1
Department of Clinical Neurosciences, Division of Neurosurgery, Geneva University Hospitals, Switzerland. Electronic address: Jean-Michel.Lemee@hcuge.ch.
2
Department of Clinical Neurosciences, Division of Neurosurgery, Geneva University Hospitals, Switzerland; Faculty of Medicine, University of Geneva, Switzerland.
3
Faculty of Medicine, University of Oslo, Norway.
4
Department of Clinical Neurosciences, Division of Neurosurgery, Geneva University Hospitals, Switzerland; Faculty of Medicine, University of Oslo, Norway; Faculty of Medicine, University of Geneva, Switzerland; Department of Neurosurgery, Oslo University Hospital, Norway.

Abstract

BACKGROUND:

Craniotomies carry inherent risks of postoperative complications that may negatively impact the patients' status. Recognizing and preventing surgical complications is of paramount importance, especially in meningioma surgery where most of these tumors are benign and current management protocols are effective in terms of disease control and maintenance of higher quality of life. The objective of this study is to describe the early complications after surgery and their predictive factors in patients undergoing resection of intra-cranial meningiomas.

METHODS:

A partly retrospective partly prospective review was conducted in a Norwegian population-based cohort of 1469 consecutive cases of meningioma surgery treated at the university hospitals of Oslo, totaling 11 414 patient-years of follow-up.

RESULTS:

2.6% of patients had a postoperative hematoma, 2.7% a postoperative infection, 3.9% a postoperative worsening of their neurological status and 5.4% of patients deceased during a 30-days period after the surgery. Predictive factors of increased risk of postoperative complications were patient's age for the hematoma, a non skull base meningioma for infection, and the occurrence of a postoperative hematoma for the risk of neurological worsening or 30-day mortality.

CONCLUSIONS:

Early postoperative complications in meningioma surgery negatively impacts patient survival and postoperative neurological status, in a disease where survival is usually not limited by the meningioma itself. In this study, we identified risk factor for early postoperative complications and the identification of at-risk populations may help to prevent their occurrence.

KEYWORDS:

complications; meningioma; outcome; predictive factors; recursive partitioning analysis

PMID:
31082552
DOI:
10.1016/j.wneu.2019.05.010

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