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Zhang JJY, Ong JAH, Tan YX, Yeo JYP, Lee KS, Goh CP, Bolem N, Tan CL, Yuan SY, Teo K, Lwin S, Yeo TT, Kirollos RW, Nga VDW. Predictors of 30-day postoperative systemic complications in geriatric patients undergoing elective brain tumor surgery. J Clin Neurosci 2021; 85:72-77. [PMID: 33581794 DOI: 10.1016/j.jocn.2020.12.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/30/2020] [Accepted: 12/17/2020] [Indexed: 11/15/2022]
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.
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Affiliation(s)
- John J Y Zhang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Jamie A H Ong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yu Xiang Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Joshua Y P Yeo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Keng Siang Lee
- Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol, UK
| | - Chun Peng Goh
- Division of Neurosurgery, Department of Surgery, National University Hospital, National University Health System, Singapore
| | - Nagarjun Bolem
- Division of Neurosurgery, Department of Surgery, National University Hospital, National University Health System, Singapore
| | - Chin Lik Tan
- Division of Neurosurgery, Department of Surgery, National University Hospital, National University Health System, Singapore
| | - Si Yang Yuan
- Division of Neurosurgery, Department of Surgery, National University Hospital, National University Health System, Singapore
| | - Kejia Teo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Neurosurgery, Department of Surgery, National University Hospital, National University Health System, Singapore
| | - Sein Lwin
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Neurosurgery, Department of Surgery, National University Hospital, National University Health System, Singapore
| | - Tseng Tsai Yeo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Neurosurgery, Department of Surgery, National University Hospital, National University Health System, Singapore
| | - Ramez W Kirollos
- Department of Neurosurgery, National Neuroscience Institute, Singapore
| | - Vincent D W Nga
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Neurosurgery, Department of Surgery, National University Hospital, National University Health System, Singapore
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Therapeutic anticoagulation for venous thromboembolism after recent brain surgery: Evaluating the risk of intracranial hemorrhage. Clin Neurol Neurosurg 2020; 197:106202. [DOI: 10.1016/j.clineuro.2020.106202] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 08/20/2020] [Accepted: 08/30/2020] [Indexed: 12/27/2022]
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