Clinical characteristics and risk factors of perioperative outcomes in elderly patients with intracranial tumors

Neurosurg Rev. 2021 Feb;44(1):389-400. doi: 10.1007/s10143-019-01217-x. Epub 2019 Dec 17.

Abstract

We aimed to study the clinical and radiological characteristics of intracranial tumors and explore the possible predictive value of these characteristics in relation to perioperative outcomes in elderly patients. We retrospectively identified 1535 elderly patients (aged 65 years and older) with intracranial tumors who underwent surgical resection between 2014 and 2018 in Beijing Tiantan Hospital. Factors associated with an increased risk of unfavorable perioperative performance and complications were investigated. Meningiomas were the most common tumors in the cohort (43.26%). The overall risk of perioperative death was 0.59%, and 42.80% of patients were discharged with unfavorable performance (Karnofsky Performance Scale [KPS] score ≤ 70). Of all patients, 39.22% had one or more complications after surgical resection. Aggressive surgery significantly lowered the rate of unfavorable perioperative outcomes (P = 0.000) with no increase in postoperative complications (P = 0.153), but it failed to be an independent predictor for perioperative outcomes in the multivariate analysis. Low performance status at admission (KPS ≤ 70) was independently associated with both unfavorable perioperative performance (P = 0.000) and complications (P = 0.000). In addition to the histopathological patterns of tumors, low performance status at admission is an independent predictor for both unfavorable perioperative performance and the occurrence of complications in elderly patients with intracranial tumors who have undergone surgical resections. However, age is not associated with perioperative outcomes in elderly patients.

Keywords: Elderly people; Intracranial; Perioperative outcomes; Tumor.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Beijing / epidemiology
  • Brain Neoplasms / mortality
  • Brain Neoplasms / pathology
  • Brain Neoplasms / surgery*
  • Cohort Studies
  • Female
  • Humans
  • Intraoperative Complications / epidemiology
  • Intraoperative Complications / mortality
  • Karnofsky Performance Status
  • Magnetic Resonance Imaging
  • Male
  • Meningioma / epidemiology
  • Meningioma / surgery
  • Middle Aged
  • Neurosurgical Procedures / adverse effects
  • Neurosurgical Procedures / methods*
  • Neurosurgical Procedures / mortality
  • Postoperative Complications / epidemiology
  • Predictive Value of Tests
  • Risk Factors
  • Sex Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome